胰腺癌的血管造影诊断与血管内治疗

目的 对63例胰腺癌的血管造影表现及血管内治疗进行总结、分析。观察胰腺癌的血管改变特征及病变侵犯的范围，为手术适应证的选择提供重要依据。资料与方法 男44例，女19例，年龄30－71岁。黄疸8例，腰背胀痛以夜间加剧为其特点。CT诊断：胰腺癌30例，其中伴肝转移12例；腹膜后占位性病变5例；脾转移癌1例；原发性肝癌27例。全部经股动脉穿刺插管行胰腺动脉造影，观察胰腺动脉及回流静脉的改变。结果 胰头癌35例，其中24例肝转移，1例脾转移；胰体部癌18例，其中12例肝转移，1例肝、脾同时转移；胰尾部癌10例，其中2例肝转移。结论 血管造影对胰腺癌的诊断可达到分类、定性、定位，同时可观察邻近大血管的受累情况，对手术适应证的选择具有十分重要的意义。在造影的同时可对病变区进行化疗，对肝内转移性病灶可行栓塞治疗。

Angiographic Diagnosis and Endovascular Treatment of Pancreatic Carcinoma (A Report of 63 Cases)

Objective To evaluate angiography and endovascular therapy in the diagnosis and treatment of pancreatic carcinoma.Materials and Methods Angiographic findings and endovascular therapeutic results in 63 cases with pancreatic carcinoma were retrospectively analyzed. Clinically, all patients complained of lumbodorsal pain, which became worse at night. CT demonstrated pancreatic carcinoma in 30 cases, of which hepatic metastasis was found in 12, retroperitoneal space occupying lesion in 5 and splenic metastasis in 1, primary liver cancer in 27 cases. All the patients underwent angiography via the femoral artery to observe the pancreatic arteries and veins.Results On angiographs, carcinoma of pancreatic head was confirmed in 35 patients, of which hepatic metastasis was accompanied in 24 and splenic metastasis in one. Carcinoma of pancreatic body was seen in 18 cases, of which hepatic metastasis was accompanied in 12 and metastasis of both the liver and the spleen in one. Carcinoma of pancreatic tail was found in 10 cases, of which hepatic metastasis was accompanied in 2.Conclusion Angiography is very helpful for the qualitative and localizing diagnosis, and for the classification of the pancreatic carcinoma. Besides, the vessels within and nearby the lesions can be observed in detail, which provides important anatomical information necessary for the surgical management.