彩色多普勒血流显像、内镜超声检查、螺旋CT、核磁共振与胰腺癌可切除性相关性的前瞻性研究
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摘要
彩色多普勒血流显像、内镜超声检查、螺旋CT、核磁共振与胰腺癌可切除性相关性的前瞻性研究
近年，胰腺癌(pancreatic cancer，PC)发病率呈上升趋势，其预后极差，1年生存率不到30％，5年生存率仅3％～7％。在我国胰腺癌发病率持续上升。目前外科手术根治性切除仍是延长其生存期的最佳选择，遗憾的是大多数胰腺癌患者在临床确诊时已属晚期，仅有10％～25％的患者能成功切除。术前准确地评估其可切除性至关重要，既可以使无法手术切除的患者免遭手术之苦，又不会使可切除患者失去手术的唯一机会。如没有发生转移，胰腺癌手术切除的可能性主要依赖于肿瘤和相邻血管组织即肠系膜上动静脉、门静脉、腹腔动脉干等的关系。我们运用彩色多普勒血流显像技术(Color Doppler Flow Imaging，CDFI)、内镜超声检查(Endoscopic Ultrasonography，EUS)、螺旋CT(Helical Computed Tomography，HCT)、核磁共振检查(Magnetic Resonance Imaging，MRI)对68例胰腺癌的肿瘤部位、肿瘤大小、毗邻脏器受侵、远处转移、淋巴结转移、血管受侵范围和程度、胰胆管扩张的程度、TNM分期以及可切除性进行了前瞻性评估和预测，并与手术和病理结果进行比较。并对同期手术治疗的26例壶腹癌四种影像学技术的肿瘤直接征象显示情况、壶腹癌与胰腺癌生物学特性的差异、TNM分期构成差异进行了比较研究。
所有连续收治适合手术治疗的胰腺癌患者于术前完成彩色多普勒血流显像技术、内镜超声检查、螺旋CT、核磁共振检查，每种影像学技术的评估均包括原发肿瘤部位、局部浸润情况、淋巴结转移、血管侵犯程度、远处转移和TNM分期和肿瘤的可切除性作出判断并与外科发现进行比较，统计学处理应用直线回归、单元和多元logistic回归分析、Kappa检验、wilcoxon检验和x~2检验、敏感性、特异性、准确性和阳性预测价值、阴性预
Pancreatic cancer is associated with an extremely poor prognosis, no more than 30% of patients can survive 1 year, and only 3%~7% of them can survive 5 years after the diagnosis. In China, the incidence of Pancreatic cancer keeps the trend of rising. Surgical resection remains the only chance for cure in these patients. However, surgical exploration without adequate preoperative attempts to determine resectability results in resection in only 10% to 25% of patients. Accurate preoperative Assessment of resectability of pancreatic carcinoma is essential to avoid unnecessary surgeries and, at the same, to not deny the opportunities for cure to patients with resectable diseases. In the absence of metastatic diseases, which clearly precludes resection, assessment of vascular invasion is the most important parameter for determining resectability in pancreatic cancer such as the anatomical relation between the tumor and superior mesenteric vein, superior mesenteric artery, portal vein and so on.
The objective of this study was to evaluate prospectively the efficacy of different strategies based on Color Doppler Flow Imaging (CDFI), Endoscopic Ultrasonography (EUS), Helical Computed Tomography(HCT), and Magnetic Resonance Imaging(MRI) in the staging and tumor resectability assessment of Pancreatic Cancer.
All consecutive patients with pancreatic carcinoma judged fit for
近年，胰腺癌(pancreatic cancer，PC)发病率呈上升趋势，其预后极差，1年生存率不到30％，5年生存率仅3％～7％。在我国胰腺癌发病率持续上升。目前外科手术根治性切除仍是延长其生存期的最佳选择，遗憾的是大多数胰腺癌患者在临床确诊时已属晚期，仅有10％～25％的患者能成功切除。术前准确地评估其可切除性至关重要，既可以使无法手术切除的患者免遭手术之苦，又不会使可切除患者失去手术的唯一机会。如没有发生转移，胰腺癌手术切除的可能性主要依赖于肿瘤和相邻血管组织即肠系膜上动静脉、门静脉、腹腔动脉干等的关系。我们运用彩色多普勒血流显像技术(Color Doppler Flow Imaging，CDFI)、内镜超声检查(Endoscopic Ultrasonography，EUS)、螺旋CT(Helical Computed Tomography，HCT)、核磁共振检查(Magnetic Resonance Imaging，MRI)对68例胰腺癌的肿瘤部位、肿瘤大小、毗邻脏器受侵、远处转移、淋巴结转移、血管受侵范围和程度、胰胆管扩张的程度、TNM分期以及可切除性进行了前瞻性评估和预测，并与手术和病理结果进行比较。并对同期手术治疗的26例壶腹癌四种影像学技术的肿瘤直接征象显示情况、壶腹癌与胰腺癌生物学特性的差异、TNM分期构成差异进行了比较研究。
所有连续收治适合手术治疗的胰腺癌患者于术前完成彩色多普勒血流显像技术、内镜超声检查、螺旋CT、核磁共振检查，每种影像学技术的评估均包括原发肿瘤部位、局部浸润情况、淋巴结转移、血管侵犯程度、远处转移和TNM分期和肿瘤的可切除性作出判断并与外科发现进行比较，统计学处理应用直线回归、单元和多元logistic回归分析、Kappa检验、wilcoxon检验和x~2检验、敏感性、特异性、准确性和阳性预测价值、阴性预
Pancreatic cancer is associated with an extremely poor prognosis, no more than 30% of patients can survive 1 year, and only 3%~7% of them can survive 5 years after the diagnosis. In China, the incidence of Pancreatic cancer keeps the trend of rising. Surgical resection remains the only chance for cure in these patients. However, surgical exploration without adequate preoperative attempts to determine resectability results in resection in only 10% to 25% of patients. Accurate preoperative Assessment of resectability of pancreatic carcinoma is essential to avoid unnecessary surgeries and, at the same, to not deny the opportunities for cure to patients with resectable diseases. In the absence of metastatic diseases, which clearly precludes resection, assessment of vascular invasion is the most important parameter for determining resectability in pancreatic cancer such as the anatomical relation between the tumor and superior mesenteric vein, superior mesenteric artery, portal vein and so on.
The objective of this study was to evaluate prospectively the efficacy of different strategies based on Color Doppler Flow Imaging (CDFI), Endoscopic Ultrasonography (EUS), Helical Computed Tomography(HCT), and Magnetic Resonance Imaging(MRI) in the staging and tumor resectability assessment of Pancreatic Cancer.
All consecutive patients with pancreatic carcinoma judged fit for
引文
1. Sohn TA, Yeo CJ, Cameron JL,et al. Resected adenocarcinoma of the pancreas 616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg, 2000, 4: 567 -579.
2. Benassai G, Mastrorilli M, Quarto G, et al. Factors influencing survival after resection for ductal adenocarcinoma of the head of the pancreas. J Surg Oncol, 2000, 73:212-218.
3. Richter A, Niedergethmann M, sturm JW, et al. Long-term results of partial panceaticcodudenectomy for ductal adenocaarcinoma of the pancreatic head: 25-year experience. World J Surg. 2003, 27:324-329.
4. Oshikawa O, Tanaka S, loka T, et al. Dynamic sonography of pancreatic tumors: comparison with dynamic CT. 2002, Am J Roentgenol, 178:1133-1137.
5. Lu DSK, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer: Criteria for unresectability of major vessels as revealed by pancreatic-phase, thin- section hecal CT. AJR 1997, 168:439-1443.
6. Tio TL, Tytgat GN. Endoscopic ultrasonography of perigastrointestinal lymph nodes. Endoscopy, 1994;26:776-779.
7. Catalano MF, sivak MV Jr, Rice T, et al. Endosonographic features predictive of lymph node metastasis. Gastrointest Endosc, 1994, 40:442-446.
8. Catalano MF, Alcocer E, Chak A, et al. Evaluation of metastatic celiac axis lymph nodes in patients with esophageal carcinoma: accuracy of EUS. Gastrointest Endosc, 1999, 50:352-356.
9. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clinical Radiology,2004, 59:26-38.
10. Jin Z, Li X, Cai L. Assessing the resectability of pancreatic ductal adenocarcinoma: comparision of dual-phase helical CT arterial portography with conventional angiography. Chin Med Sci J. 2001 Mar; 16: 40-45.
11．林国为，沈福民．现代临床流行病学．上海医科大学出版社，第1版，2000：56-58．
12. NakayamaY, yamashita Y, Kadota M, et al. Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assist Tomogr, 2001, 25: 337-342.
13. Sironi S, De Cobilli F, Zerbi A, et al. Pancreatic carcinoma: MR assessment of tumor invasion of the peripanceatic vessels. J Comput Assist Tomogr, 1995, 19: 739-744.
14. Kahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. Hepato-Gastroenterology, 2000, 47: 545-549.
15. House MG, Yeo CJ, Cameron JL, Predicting resectability of periampullary cancer with three-dimensional computed tomography. J Gastrointest Surg. 2004, 8: 280-288.
16. Scaglione M, Pinto A, Romano S, et al. Using multidetector row computed tomography to diagnose and stage pancreatic carcinoma: the problems and the possibilities. JOP. 2005, 13; 6: 1-5
17. DeWitt J, Devereaux B, Chriswell M, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004, 16; 141: 753-763.
18. Grenacher L, Klauss M, Dukic L, et al. Diagnosis and staging of pancreatic carcinoma: MRI versus multislice-CT--a prospective study Rofo. 2004; 176: 1624-1633.19. Soriano A, Castells A, Ayuso C, et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 2004, 99: 492-501.
20. Andre T, Balosso J, Louvet C, et al. Adenocarcinoma of the pancreas. Diagnosis and evaluation. Presse Med, 1998, 27: 537-538.
21. Reddy KR, Levi J, Livingstone A, Jeffers L, et al. Experience with staging laparoscopy in pancreatic malignancy. Gastrointest Endosc 1999, 49: 498-503.
22. Razak H, Ladny JR, Laszkiewicz J, et al. Diagnosis and surgical treatment of pancreatic carcinoma. Wiad Lek, 1999, 52: 480-487.
23. Takeuchi M, Kondo S, Surgiura H, et al. Preoperative predictors of short-term survival after pancteatic cancer resection. Hepatogastroenterology, 1998, 45: 2399-2403.
24. Rosch T, Schusdziarra V, Born P, et al. Modern imaging methods versus clinical assessment in the evaluation of hospital in-patients with suspected pancreatic disease. Am J Gastroenterol, 2000, 95: 2261-2270.
25. Bunk A, Pistorius S, Konopke R. The value of colour duplex sonography in the assessment of surgical resectability of pancreatic tumors. Ultraschall Med, 2001, 22: 265-273.
26. Yamao K, Okubo K, Sawaka A, et al. Endolumenal ultrasonography in the diagnosis of pancreatic diseases. Abdom Imaging, 2003, 28: 545-555.
27. Opacic M, Rustemovic N. Endoscopic ultrasonography and diagnostic algorithms in diseases of the gastrointestinal tract. Lijec Vjesn, 2003, 125: 192-199.28. Squilaci E, Fanucci E, Sciuto E, et al. Vascular involvement in pancreatic neoplasm a comparison between spiral CT and DSA. Digestive Diseases and Sciences, 2003, 48, 449-458.
29. Phoa SSKS, Reeders WA, Stoker J, et al. CT criteria for venous invasion in patients with pancreatic head carcinoma. Br J Radiol, 2000; 73: 1159-1164.
30. Freeny PC, traverso LW, Ryan JA. Diagnosis and staging of pancreatic adenocarcinoma with dynamic computed tomography. Am J Surg, 1993, 165: 600-606.
31. Loyer EM, davad CL, dubrow RA, et al. Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT. Abdom Imaging, 1996; 21: 202-206.
32. Vails c, Andia E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR, 2002; 178: 821-826.
33. Brugel M, Rummeny EJ, Dobritz M. Vascular invasion in pancreatic cancer: value of multislice helical CT. Abdom Imaging, 2004, 9: 239-245.
34. Huang QJ, Xu Q, Wang XN, et al. Hepatobiliary Pancreat Dis Int. 2002, 1: 614-619.
35. Minniti S, Bruno C, Biasiutti C, et al. Sonography versus helical CT in identification and staging of pancreatic ductal adenocarcinoma. Journal of Ultrosound, 2003, 31: 175-182.
36. Morrin MM, Kruskal JB, Raptopoulos V, et al. State of the art US is as accurate as helical CT angiography for detecting unresectable periampullary carcinoma. Ultrasound Med, 2001, 20: 481-490.
37. Vargas R, Nino-Murcia M, Trueblood W, et al. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations.??AJR Am J Roentgenol. 2004, 182:419-425.
38. Martin EO, Giles WL, Bradford JW, et al. Adenocarcinoma of the head of the pancreas: determination of surgical unresectability with thin section pancreatic phase helical CT. AJR, 1999, 173:1513-1518.
39. Alec JM, Xiao HZ, Heidrun R, et al. Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of respectability2report of the radiology diagnositic oncology group. Radiology, 1995, 195:327-332.
40. Taiji N, Yasuyuki Y, Yasuko A, et al. Local extension of pancreatic carcinoma: assessment with thin2section helical CT versus with breath2hold fast MR imaging2ROC analysis. Radiology,1999, 212: 445-452.
41. Maria BS, Janice WJ, Ashley G, et al. Dynamic contrast2enhanced MR imaging and dual2phase helical CT in the preoperative assessment of suspected pancreatic cancer: a comparative study with receiver operating characteristic analysis.AJR, 999, 173:583-590.
42. Bennett GL, Hann LE. Pancreatic ultrasonography. Surg Clin North Am, 2001, 81:259-283.
43. Roche CJ, Hughes ML, Garvey CJ, et al. CT and pathologic assessment of prospective nodal staging in patientswith ductal adenocarcinoma of the head of the pancreas. Am J Roentgenol 2003,180: 475-480.
44. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging. 2003,28:556-562.
45. Durbin TE, Chang KJ. Endoscopic ultrasound (EUS)criteria for predicting malignant lymph nodes using linear array and radialscans: Correlation with EUS-guided fine needle aspiration(FNA). Gastrointest Endosc 1996; 43:A5109(abstract).
46. Eloubeidi MA, Jhala D, Chhieng DC, et al., Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma. Cancer, 2003,99:285-292.
47. Varshney S, Hacking CN, Johnson CD. CT arterial portography in staging pancreatic malignancy. Int J Pancreatol, 2000,28:61-67.
48. Bluemke DA, Cameron JL, Hruban RH, et al. Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology, 1995,197:381-385.
49. Grutzmann R, Bunk A, Kersting S, et al. Prospective evaluation of ultrasound and colour duplex imaging for the assessment of surgical resectability of pancreatic tumours. Langenbecks Arch Surg,2003, 388:392 - 400.
50. Benson MD, Gandhi MR. Ultrasound of the hepatobiliary-pancreatic system. World J Surg, 2000, 24:166 - 170.
51. Gandolfi L, Torresan F, Solmi L, et al. The role of ultrasound in biliary and pancreatic diseases. Eur J Ultrasound. 2003,16:141-159.
52. Soto JA, Barish MA, Yucel KE, et al. Pancreatic duct: MR cholangiopancreatography with a three-dimentional fast spin-echo technique. Radiology 1995,196:459-464.
53. Lomanto D, Pavone P, Laghi A, et al. Magnetic resonance cholangiopancreatography in the diagnosis of biliopancreatic diseases. Am J Surg 1997,174:33-38.
54. Miyazaki T, Yamashita Y, Tsuchigame T, et al. MR cholangiopancreatography using HASTE(half-Fourier acquisition single-shot turbo spin-echo) sequences. AJR 1996,166:1297-303.
55. Barish MA, Yucel KE, Soto JA, et al. MR cholangiopancreatography: Efficacy of three dimentional turbospinecho technique. AJR 1995, 165: 295-300.
56. Tamm E, Charnsangavej C. Pancreatic cancer: current concepts in imaging for diagnosis and staging. 2001, Cancer J, 7: 298-311.
57. Ishida H, Konno K, Hamashima Y. Assessment of resectability of pancreatic carcinoma by colour Doppler sonography. Abdom Imaging, 1999, 24: 295-298.
58. Carlo Catalano, Andrea Laghi, Francesco Fraioli, et al. Pancreatic carcinoma: the role of high-resolution multislice spiral CT in the diagnosis and assessment of resectability. Eur Radiol, 2003, 13: 149-156.
59. Shima W, Rugger R, Schober E, et al. Diagnosis and staging of pancteatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CT. AJR, 2002, 179: 717-724.
60. Diehl SJ, Lehmann KJ, Sadick M, et al. Pancreatic cancer: Value of dual-phase helical CT in assessing resectability. Radiology 1998, 206: 373-8.
61. Zeman RK, Cooper C, Zeiberg AS, et al. TNM staging of pancreatic carcinoma using helical CT. AJR 1997, 169: 459-64.
62. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging. 2003, 28: 556-562.
63. Calculli L, Casadei R, Amore B, et al. The usefulness of spiral Computed Tomography and colour-Doppler ultrasonography to predict portal-mesenteric trunk involvement in pancreatic cancer. Radiol Med(Torino). 2002, 104: 307-15.
64. Queneau PE, Sauve1 G, Koch1 S, et al. The Impact on Clinical Practice of Endoscopic Ultrasonography Used for the Diagnosis and Staging of Pancreatic Adenocarcinoma. J Pancreas, 2001, 2:??98-104.
65. Tierney WM, Francis IR, Eckhauser F, et al. The accuracy of EUS and helical CT in the assessment of vascular invasion by periampullary malignancy. Gastrointest Endosc, 2001,53:182-187.
66. Gabata T, Matsui O, Kadoya M, et al. smallpancreatic adenocarcinoma: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology,1994, 193:683-688.
67. Semelka RC, Kroeker MA, Shoenut JP, et al. pancreatic disease: prospective comparison of CT, ERCP, and 1.5 T MR imaging with dynamic gadolinium enhancement and fat suppression. Radiology, 1991,181:785-791.
68. Vellet AD, Romano W, Bach DB, et al. Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5T. Radiology, 1992, 183:87-95.
69. Sittek H, Heuck AF, Folsing C, et al. Static and dynamic MR tomography of the pancreas: contrast media kinetics of the normal pancreatic parenchyma in pancreatic carcinoma and chronic pancreatitis. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr, 1995, 162: 396-403.
70. Mirowitz SA, Gutierrez E, Lee JK, et al. Normal abdominal enhancement patters with dynamic gadolinium-enhanced MR imaging. Radiology, 1991,180:637-640.
71. Reiber A, Tomczak R, Nussle K, et al. MRI with mangafodipir trisodium in the detection of pancreatic tumours: comparison with helical CT. Br J Radiol, 2000, 73:1165-1169.
72. Fayad LM, Mitchell DG. Magnetic resonance imaging of pancreatic adenocarcinoma. 2001, lnt J Gastrointest Cancer 30:19 - 25.
73. Maire F, Sauvanet A, Trivin F, et al. Staging of pancreatic head adenocarcinoma with spiral CT and endoscopic ultrasonography:an indirect evaluation of the usefulness of laparoscopy. Pancreatology. 2004, 4:436-40.
74. Yusoff IF, Mendelson EM, Edmunds SEJ, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Adom Imaging, 2003, 28:556-562.
75. Arslan A, Buanes T, Geitung JT. Pancreatic carcinoma: MR, MR angiography and dynamic helical CT in the evaluation of vascular invasion. Eur J Radiol, 2001,38:151-159.
76. akahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. Hepatogastroenterology, 2000, 47: 545 - 549.
77. Nakeeb A, Lillemoe KD, Grosfeld JL. Surgical techniques for pancreatic cancer. Minerva Chir. 2004,59:151-63.
78. Aramaki M, Matsumoto T, Etoh T, et al. Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma. Hepatogastroenterology. 2003, 50: 263 -266.
79. Richter A, Gaa J, Niedergethmann M, et al. Ultrafast magnetic resonance tomography changes the standard in pancreas diagnosis. Chirurg, 2001, 72:697 - 703.
80. Menack MJ, Spitz JD, Arregui ME. Staging of pancreatic and ampullary cancers for resectability using laparoscopy with laparoscopic ultrasound. Surg Endosc, 2001,15:1129 - 1134.
81. Barreiro CJ, Lillemoe KD, Koniaris LG, et al. Diagnostic laparoscopy for periampullary and pancreatic cancer: what is the true benefit? J Gastrointest Surg, 2002, 6:75 - 81.
82. Brooks AD, Mallis M, Brennan MF, et al. The value of laparoscopy in the management of ampullary, duodenal, and distal bile ducttumors. J Gastrointest Surg, 2002, 6: 139-146.
83. Barreiro CJ, Lillemoe KD, Koniaris LG, etal. Diagnostic Laparoscopy for Periampullary and Pancreatic Cancer: What Is the True Benefit? J Gastrointest Surg, 2002, 6: 75-81.
84. Domagk D, Poremba C, Dietl KH, et al. Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study. 2002, Gut 51: 240-244.
85. Velanovich V. The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer. Surg Endosc. 2004, 18: 310-313.1. Lindell G, Borch K, Tingstedt B,et al. Management of cancer of the ampulla of Vater: does local resection play a role? Dig Surg, 2003, 20:511-515.
2. Kimura W, Futakawa N, Zhao B. Neoplastic diseases of the papilla of Vater. J Hepatobiliary Pancreat Surg, 2004, 11:223-231.
3. Zhou H, Schaefer N, Wolff M, et al. Carcinoma of the ampulla of Vater: comparative histologic/immunohistochemical classification and follow-up. Am J Surg Pathol, 2004, 28:875-882.
4. Wang LF, Hingorani SR, Tuveson DA. et al. Detecting and diagnosing ampullary neoplasms. Cancer Biol Ther, 2004, 3: 657 - 659.
5. Beger HG, Thorab FC, Liu Z, et al. Pathogenesis and treatment of neoplastic diseases of the papilla of Vater: Kausch-Whipple procedure with lymph node dissection in cancer of the papilla of Vater. J Hepatobiliary Pancreat Surg,2004, 11:232-238.
6. Duffy JP, Hines OJ, Liu JH, et al. Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg, 2003, 138:941-948.
7. Todoroki T, Koike N, Morishita Y, et al. Patterns and predictors of failure after curative resections of carcinoma of the ampulla of Vater. Ann Surg Oncol, 2003,10:1176-1183.
8. Schwarz RE, Smith DD, Keny H. Impact of intraoperative radiation on postoperative and disease-specific outcome after pancreatoduodenectomy for adenocarcinoma: a propensity score analysis. Am J Clin Oncol,2003, 26:16-21.
9 Nakano K, Chijiiwa K, Toyonaga T, et al. Combination therapy of resection and intraoperative radiation for patients with carcinomas ofextrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone? Hepatogastroenterology, 2003, 50: 928-933.
10. Wiedmann M, Schoppmeyer K, Witzigmann H, et al. [Current diagnostics and therapy for carcinomas of the biliary tree and gallbladder. Z Gastroenterol, 2005, 43:305-315.
11. Wang CH, Mo LR, Lin RC, et al. A survival predictive model in patients undergoing radical resection of ampullary adenocarcinoma. Hepatogastroenterology,2004,51:1495-1499.
12. Hidekazu M et al. Evaluation of endoscopic ultrasonography in the diagnosis of cancer of the papilla of vater. Gastroenterol Endosc, 1990, 32:355
13. Andersen HB, Pihl HE, Tjalve E, Burcharth F. CT diagnosis of pancreatic or periampullary cancer. Ugeskr Laeger 1994; 156: 7534-7537.
14. Kim JH, Kim MJ, Chung JJ, et al. Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics, 2002, 22:1335-1352.
15. AI-Mofleh IA, AI-Rashed RS, AI-Amri SM, et al. Malignant biliary strictures. Diagnosis and management. Saudi Med J, 2003,24:1360-3.
16. Vaishali MD, Agarwal AK, Upadhyaya DN, et al. Magnetic resonance cholangiopancreatography in obstructive jaundice. J Clin Gastroenterol, 2004, 38:887-90.
17. Schwartz LH, Lefkowitz RA, Panicek DM. et al. Breath-hold magnetic resonance cholangiopancreatography in the evaluation of malignant pancreaticobiliary obstruction. J Comput Assist Tomogr, 2003, 27:307-314.
18. Skordilis P, Mouzas IA, Dimoulios PD, et al. Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study. BMC Surg, 2002, 2:1-5.
19. Yasuda K, Mukai H, Fujimoto S, et al. The diagnosis of pancreaticcancer by endoscopic ultrosonography. Gastrointestinal Endosc, 1988, 34:1.
20. Sivak MVK, Aufman A. Endoscopic ultrosonography in the differential diagnosis of pancreatic diagnosis. Scand J Gastroenterol, 1986, 123(Suppl): 130-135.
21. Tio TL, Tytgat GN. Endoscopic ultrasonography of normal and of pathologic upper gastrointestinal wall structure. Scand J Gastroenterol, 1986,123(Suppl):27-31.
22. Quirk DM, Rattner DW, Fernandez-del Castillo C, Warshaw AL, Brugge WR. The use of endoscopic ultrasonography to reduce the cost of treating ampullary tumors. Gastrointest Endosc 1997;46: 334-347.
23. Jarufe NP, Coldham C, Mayer AD, et al. Favourable prognostic factors in a large UK experience of adenocarcinoma of the head of the pancreas and periampullary region. Dig Surg,2004; 21:202-209.
24. Martin JA, Haber GB. Ampullary adenoma: clinical manifestations, diagnosis, and treatment. Gastrointest Endosc Clin N Am, 2003, 13:649-669.
25. Paramythiotis D, Kleeff J, Wirtz M, et al. Still any role for transduodenal local excision in tumors of the papilla of Vater? J Hepatobiliary Pancreat Surg, 2004, 11:239-44.
26. Sherlock, SH.; Dooley, J. Disease of the liver and biliary system.9.London: Blackwell scientific publications.;1993. Disease of the Ampulla of Vater and Pancreas, P.599-605.
27. Sellner FJ, Riegler FM, Machacek E. Implications of histological grade of tumour for the prognosis of radically resected periampullary adenocarcinoma. Eur J Surg, 1999,165: 865-870.
28. Yasuda K, Mukai H, Fujimoto S, et al. The diagnosis of pancreatic cancer by endoscopic ultrosonography. Gastrointestinal Endosc,1988, 34: 1-5.
29. Sivak MVK, Aufman A. Endoscopic ultrosonography in the differential diagnosis of pancreatic diagnosis. Scand J Gastroenterol, 1986, 123 (Suppl): 130-136.
30. Schwarz M, Pauls S, Sokianski R, et al. Is a peroperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective? Am J Surg, 2001, 182: 243-249.1. Wang L, Yang GH, Lu XH, et al. Pancreatic cancer mortality in China(1991-2000). World J Gastroenterol, 2003, 9: 1819-1823
2. Jemal A, Tiwari RC, Murray T, et al. Cancer statistics, 2004. CA Cancer J Clin, 2004, 54: 8-29.
3. NakayamaY, yamashita Y, Kadota M, et al. Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assist Tomogr, 2001, 25: 337-342.
4. Sironi S, De Cobilli F, Zerbi A, et al. Pancreatic carcinoma: MR assessment of tumor invasion of the peripanceatic vessels. J Comput Assist Tomogr, 1995, 19: 739-44.
5. Warshaw AL, Gu ZY, wittenberg J, et al. Preoperative staging and assessment of resectability of pancreatic cancer. Arch surg, 1990, 125: 230-3.
6. Warshaw AL, Fernandez-del Castillo C. Pancreatic carcinoma. N Engl J Med, 1992; 326: 455-65.
7. Takahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. HepatoGastroenterology, 2000, 47: 545-549.
8. Aramaki M, Matsumoto T, Etoh T, et al. Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma. Hepatogastroenterology. 2003; 50: 263-266.9. Park DI, Lee JK, Kim JE, et al. The analysis of resectabilty and survival in pancreatic cancer patients with vascular invasion. J Clin Gastroenterol, 2001, 32:231-234.
10. Howard TJ, Chin AC, Streib EW, et al. Value of helical computed tomography, angiography, and endoscopic ultrasound in determining resectability of periampullary carcinoma. Am J Surg, 1997,174:237-241.
11. Tierney WM, Francis IR, Eckhauser F, et al. The accuracy of EUS and helical CT in the assessment of vascular invasion by peripapillary malignancy. Gastrointest Endosc, 2001, 53:182-188.
12. Tierney WM, Fendrick AM, Hirth RA, et al. The clinical and economic impact of endoscopic ultrosound in the staging of pancreatic cancer. Am J Gastroenterol, 2000, 95:1708-1713.
13. Tierney WA, Hirth RA, Fendrick AM, Scheiman JM. The clinical and economic impact of endoscopic ultrasound, MRA, and helical CT in the staging of pancreatic cancer. Gastrointrrointest Endosc 1997;15:81-89.
14. Bennett GL, Hann LE. Pancreatic ultrasonography. Surg Clin North Am 2001, 81:259-283.
15. Grutzmann R, Bunk A, Kersting S, et al. Prospective evaluation of ultrasound and colour duplex imaging for the assessment of surgical resectability of pancreatic tumours. Langenbecks Arch Surg. 2003; 388:392-400.
16. Minniti S, Bruno C, Biasiutti C, et al. Sonography versus helical CT in identification and staging of pancreatic ductal adenocarcinoma. J Clin Ultrasound, 2003;31:175-182.
17. Shams J, Stein A, Cooperman AM. Computed tomography for pancreatic diseases. Surg Clin of North Am, 2001, 81:283-306.
18. Scaglione M, Pinto A, Romano S, et al. Using multidetector rowcomputed tomography to diagnose and stage pancreatic carcinoma: the problems and the possibilities. JOP, 2005,13; 1-5.
19. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clin Radiol. 2004;59:26-38.
20. Bluemke DA, Cameron JL, Hruban RH, et al. Potentially resectable pancreatic adenocarcinoma: Spiral CT assessment with surgical and pathologic correlation. Radiology 1995; 197:381-385.
21. Megibow AJ, Zhou XH, Rotterdam H, et al. Pancreatic adenocarcinoma. CT versus MR imaging in the evaluation of resectability. Radiology Diagnotic Oncology Group. Radiology 1995;195:327-332.
22. McCarthy MJ, Evans J, Sagar G et al. Prediction of resectability of pancreatic malignancy by computed tomography. Br J Surg 1998;85:320-325.
23. Tio TL, Tytgat GNJ, Cikot RGLM, et al. Ampullopancreatic carcinoma: preoperatice TNM classification with endosonography. Radiology. 1990;175:455-461.
24. Rosch T, Braig C, Gain T, et a.Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography: comparison with convention sonography, computed tomography, and angiography. Gastroenterology. 1992,102: 188-199.
25. Dupuy DE, Costello P, Ecker CP. Spiral CT of the pancreas. Radiology 1992,183: 815-8.
26. Lu DS, Vedantham S, Krasny RM, et al. Two-phase helical CT for pancreatic tumors: Pancreatic versus hepatic phase enhancement of tumor, pancreas. And vascular structure. Radiology, 1996, 199: 697-701.
27. Lu DS, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer: Criteria for unresectability of major vessels as revealed bypancreatic-phase, thin-section hecal CT. A JR 1997, 168: 1439-1443.
28. Boland GW, O'Malley ME, Saez M, et al. Pancreatic-phase versus portal vein-phase helical CT of the pancreas: Optimal temporal window for evaluation of pancreatic adenocarcinoma. AJR, 1999, 172: 605-608.
29. Zeman RK, Cooper C, Zeiberg AS, et al. TNM staging of pancreatic carcinoma using helical CT. AJR 1997, 169: 459-464.
30. Diehl SJ, Lehmann KJ, Sadick M, et al. Pancreatic cancer: Value of dual-phase helical CT in assessing resectability. Radiology 1998, 206: 373-378.
31. Vedantham S, Lu DSK, Reber HA, et al. Small peripancreatic veins: improved assessment in pancreatic cancer patients using thin-section pancreatic phase helical CT. AJR, 1998, 170: 377-383.
32. Loyer EM, davad CL, dubrow RA, et al. Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT. Abdom Imaging, 1996; 21: 202-206.
33. valls c, Andia E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR, 2002; 178: 821-826.
34. Brugel M, Rummeny EJ, Dobritz M. Vascular invasion in pancreatic cancer: value of multislice helical CT. Abdom Imaging. 2004; 29: 239-245.
35. Vargas R, Nino-Murcia M, Trueblood W, etal. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol. 2004; 182: 419-425.
36. House MG, Yeo CJ, Cameron JL, et al. Predicting resectability of periampullary cancer with three-dimensional computed tomography. J Gastrointest Surg. 2004; 8: 280-288.37. varshney S, hacking CN, Johnson CD. CT arterial portography in the staging of pancreatic maligmency. International journal of pancreatology, 2000;28:61-67.
38. Raptopoulos V, steer ML, Sheiman RG, et al. The use helical CT and CT angiography to predict vascular involvement from pancreatic cancer: correlation with findings at surgery. AJR, 1997, 168:971
39. Squillaci E, Fanucci E, Sciuto F, et al. Vascular involvement in pancreatic neoplasm: a comparison between spiral CT and DSA. Dig Dis Sci, 2003; 48:449-458.
40. Menack MJ, Spitz JD, Arregui ME. Staging of pancreatic and ampullary cancers for resectability using laparoscopy with laparoscopic ultrasound. Surg Endosc, 2001, 15:1129-134.
41. Launois B, stasik C, bardaxoglou E, et al. Who benefits from portal vein resection during pancreaticoduodenectomy for pancreatic cancer? World J Surg, 1999,23:926-929.
42. Ishiguchi T, Ota T, Naganawa S, CT and MR imaging of pancreatic cancer. Hepatogastroenterology. 2001; 48:923-7.
43. Murakami K, Nawano S, Moriyama N, et al. Usefulness of magnetic resonance imaging with dynamic contrast enhancement and fat suppression in detecting a pancreatic tumor. Jpn J Clin Oncol, 1998,28:107-111.
44. Ichikawan T, Haradome H, Hachiya J, et al. Pancreatic ductal adenocarcinoma: Preoperative assessment with helical CT versus dynamic MR imaging. Radiology 1997,202:655-662.
45. Irie H, Honda H, Kaneko K, et al. Compariaon od helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma. Abdomin Imag 1997,22:429-433.
46. Taylor AM, Roberts SA, Manson JM. Experience with laparoscopicultrasonography for defining tumour resectability in carcinoma of the pancreatic head and periampullary region. Br J Surg, 2001, 88, 1077-1083.
47. Sadick M, Diehl SJ, Lehmann KJ, et al. Evaluation of breath-hold contrast-enhanced 3D magnetic resonance angiography technique for imaging visceral abdomonal arteries and veins. Invest Radiol 2000, 35: 111-117.
48. Grenacher L, Klauss M, Dukic L, et al. Diagnosis and staging of pancreatic carcinoma: MRI versus multislice-CT--a prospective study. Rofo. 2004, 176: 1624-1633.
49. Reihoid C, Bret PM. Current status of MR cholangiopancreatography. AJR 1996; 166; 1285-1295.
50. Soto JA, Barish MA, Yucel KE, et al. Pancreatic duct: MR cholangiopancreatography with a three-dimentional fast spin-echo technique. Radiology 1995, 196: 459-464.
51. Lomanto D, Pavone P, Laghi A, et al. Magnetic resonance cholangiopancreatography in the diagnosis of biliopancreatic diseases. Am J Surg 1997, 174: 33-38.
52. Miyazaki T, Yamashita Y, Tsuchigame T, et al. MR cholangiopancreatography using HASTE(half-Fourier acquisition single-shot turbo spin-echo) sequences. AJR 1996, 166: 1297-303.
53. Barish MA, Yucel KE, Soto JA, et al. MR cholangiopancreatography: Efficacy of three dimentional turbo spinecho technique. AJR 1995, 165: 295-300.
54. lorenz M, Heinrich S, Staib-Sebler E, et al. Regional chemotherapy in the treatment of advanced pancreatic cancer-is it relevant? Eur J Cancer, 2000, 36: 957-965.
55. Ahmad NA, Kochman ML, Lewis JD, et al. Endosonography is superior to angiography in the preoperative assessment of vascular??involvement among patients with pancreatic carcinoma. J Clin Gastroenterol, 2001,32:54-58.
56. Sladinger PF, et al. J Gastrointest Surg, 2000, 4(3):233-237.
57. Heertum RLV, Fawwaz RA. The role of nuclear medicine in the evaluation of pancreatic disease. Surgical Clinics of North America, 2001,81(2):345-358.
58. Nakata B, Nishimura S, Ishikawa T, et al. Prognostic predictive value of _(18)F-fluorodeoxyglucose positron emission tomography for patients with pancreatic cancer. Int J oncol, 2001, 19:53-58.
59. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging, 2003; 28:556-562.
60. Palazzo L, Roseau G, Gayet B, et al. Endoscopic ultrsonography in the diagnosis and staging of pancreatic adenocarcinoma: Results of a prospective study with comparison to ultrasonography and CT scan. Endoscopy 1993,25:143-150.
61. Bhuani MS. Endoscopic ultrasound in pancreatic diseases indications, limitations, and the future. Gastroenterology Clinic of North America, 1999, 28:747-770.
62. Lok Tio T, Hoei Sie L, Kallimanis G, et al. Staging of ampullary and pancreatic carcinoma: Comparson between endosonography and surgery. Gastrointest Endosc 1996,44:706-713.
63. Yasuda K, Mukai H, Nakajima M, et al. Staging of pancreatic carcinoma by endoscopic ultrasonography. Endoscopy 1993, 25:151-5.
64. Rosch T, Lorenz R, Braig C, et al. Endoscopic ultrasonography in diagnosis and staging of pancreatic and biliary tumors. Endoscopy 1992; 24(suppl 1): 304-308.
65. DeWitt J, Devereaux B, Chriswell M, et al. Comparison ofendoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004, 141: 753-63.
66．田艳涛，赵平，王成峰，等．内镜超声检查对胰腺癌可切除性的评估．中华消化内镜杂志，2004，21：232-234．
67. SnadyH, BrucknerH, SiegelJ, etal. Endoscopic ultrasono-graphic criteria of vascular invasion by potentially respectable pancreatic tumors. Gastrointest Endosc, 1994, 40: 326.
68. tio TL, Tytgat GN. Endoscopic ultrasonography in staging local respectability of pancreatic and periaampullary malignandy. Scand J Gastroenterol, 1986, (Suppl): 135.
69. Durbin TE, Chang KJ. Endoscopic ultrasound (EUS)criteria for predicting malignant lymph nodes using linear array and radial scans: Correlation with EUS-guided fine needle aspiration(FNA). Gastrointest Endosc 1996; 43: A5109(abstract).
70. Chang KJ, Katz KD, Durbin TE, et al. Endoscopic ultrasound-guided fine-needle aspiration. Gasteointesrt Endosc 1994, 40: 694-700.
71. Schwarz M, Pauls S, Sokianski R, et al. Is a peroperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective? Am J Surg, 2001, 18, 182: 234-249.
72. Rodriguez J, Kasberg C, Nipper M, et al. CT-guided needle biopsy of the pancreas. A retrospective analysis of diagnostic accuracy. Am J Gastroenterol 1992, 87: 1601-1603
73. Pinto MM, Avila NA, Criscuolo EM. Fine needle aspiration of the pancreas: Five year experience. Acta Cytol 1988, 32: 39-42.
74. Chang KJ, Wiersema M, et al. Multi-center collaborative study on endoscopic ultrasound(eusOguided fine needle aspiration (FNA) of??the pancreas. Gastrointest Endosc 1996, 43:A507(abstract).
75. Ryan ME. Cytologic brushings of ductal lesions during ERCP. Gastrointest Endosc 1991,37:139-142.
76. Ferrari A, Lichtenstein D, Slivka A, et al. Brush cytology during ERCP for the diagnosis of biliary and pancreatic malignancies. Gastrointest Endosc, 1994, 40:140-145.
77. Chang K, Nguyen P. Erickson RA, et al. The clinical utility of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) on the diagnisis and staging of pancreatic carcinoma. Gastrointest Endosc 1997,45:387-393.
78. Wiersema MJ. Identifying contraindications to resection in patients with pancreatic carcinoma: the role of endoscopic ultrasound. Can J Gastroenterol. 2002; 16:109-114.
79. Legmann P, Vignaux O, Dousset B, et al. Pancreatic tumors: Comparison of dual-phase helical CT and enloscopic sonography. AJR 1998,170:1315-1322.
80. L(?)vy P, Boudet MJ, Zins M, et al. Preoperative nonresectability criteria used for pancreatic head adenocarcinoma: a practical survey among gastroenterologists and surgeons. Pancreas, 2000,21(4): 333-337.
81. Maire F, Sauvanet A, Trivin F, et al. Staging of pancreatic head adenocarcinoma with spiral CT and endoscopic ultrasonography: an indirect evaluation of the usefulness of laparoscopy. Pancreatology. 2004;4:436-440.
82. Velanovich V. The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer. Surg Endosc. 2004;18:310-313.
83. Tada M, Omata M, kawai S, et al. Detaction of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreaticadenocarcinoma. Cancer Res, 1993,53:2472-2474.
84. Mohiuddin M, ahmed MM, Venkatasubbarao K. c-Ki-ras mutation in peripherial blood of pancreatic cancer patients: A marker for early tumor metastasis. Int J Radiat Oncol Biol Phys 1996,34:161-166.
85. Izbicki JR, Hosch SB, pichlmeier U, et al. Prognostic value of immunohistochemically identifiable tumor cells in lymph nodes of patients with completely resected esophageal cancer. N Engl J Med, 1997,337:1188-1194.
86. Schott A, vogel I, Krueger U, et al. Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker. Ann Surg, 1998, 227:372-379.
87. Jauch KW, Heiss MW, Gruetzner U, et al. Prognostic significence of bone marrow micrometastases in patients with gastric cancer. J Clin Oncol, 1996,14:1810-1817.
88. Diel IJ, Kaufmann M, Costa SD, et al. Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comprison with nodal status. J Natl cancer Inst, 1996,88:1652-1658.
89. Z'graggen K, Centeno BA, Castillo CF, et al. Biological implications of tumor cells in blood and bone marrow of pancreatic cancer patients. Sugery, 2001, 129(5):537-546.
90. Makary MA, warshaw AL, centeno BA, et al. Implications of peritoneal cytology for pancreatic cancer management. Arch Surg, 1998,133:361-365.
91. Schmidt J, Fraunhofer S, Fleisch M, et al. Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma? Hepatogastroenterology. 2004;:1827-1831.
92. Schlieman MG, Ho HS, Bold RJ. Utility of tumor markers in determining respectability of pancreatic cancer. Arch Surg, 2003, 138: 951-956.
93. He YC, Peng W, Qiao J, et al. Relationship between nuclear morphometry, DNA content and resectability of pancreatic cancer. World J Gastroenterol 2003; 9: 1863-1865.
94. Weger AR, Glaser KS, Schwab G, et al. Quantitative nuclear DNA content in fine needle aspirates of pancreatic cancer. Gut, 1991; 32: 325-328.
95. Joeusuu H, Alanen KA, Klemi PJ. Doubts on "curative" resection of pancreatic cancer. Lancet, 1989; 1: 953-954.
96. Williams DS, Sahai AV, Aabakken L, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut, 1999; 44: 720-726.
97. Soriano A, Castells A, Ayuso C, et al. Preoperative Staging and Tumor Resectability Assessment of Pancreatic Cancer: Prospective Study Comparing Endoscopic Ultrasonography, Helical Computed Tomography, Magnetic Resonance Imaging, and Angiography. Am J Gastroenterol, 2004; 99: 492-501.
98. Elixhauser A, Halpern MT. Economic evaluations of gastric and pancreatic cancer. Hepatogastroenterology, 1999, 46: 1206-1213.
99. Mcmahon PM, Haalpern EF, Fernandez-del castillo C, et al. Pancreatic cancer: cost-effective of imaging technologies for assessing resectability. Radiology, 2001, 221: 93-106.
100．田艳涛，赵平．前瞻性评估胰腺癌可切除性研究进展．中国肿瘤临床与康复．2003，11：182-185．
101. Nakeeb A, Lillemoe KD, Grosfeld JL. Surgical techniques for pancreatic cancer. Minerva Chir. 2004; 59: 151-63.
102. House MG. Predicting resectability of periampullary cancer with??three-dimensional computed tomography. J Gastrointest Surg. 2004, 8:280-288.
103. Vargas R. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. Am J Roentgenol. 2004,182:419-425.
104. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clin Radiol, 2004, 59:26-30.
2. Benassai G, Mastrorilli M, Quarto G, et al. Factors influencing survival after resection for ductal adenocarcinoma of the head of the pancreas. J Surg Oncol, 2000, 73:212-218.
3. Richter A, Niedergethmann M, sturm JW, et al. Long-term results of partial panceaticcodudenectomy for ductal adenocaarcinoma of the pancreatic head: 25-year experience. World J Surg. 2003, 27:324-329.
4. Oshikawa O, Tanaka S, loka T, et al. Dynamic sonography of pancreatic tumors: comparison with dynamic CT. 2002, Am J Roentgenol, 178:1133-1137.
5. Lu DSK, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer: Criteria for unresectability of major vessels as revealed by pancreatic-phase, thin- section hecal CT. AJR 1997, 168:439-1443.
6. Tio TL, Tytgat GN. Endoscopic ultrasonography of perigastrointestinal lymph nodes. Endoscopy, 1994;26:776-779.
7. Catalano MF, sivak MV Jr, Rice T, et al. Endosonographic features predictive of lymph node metastasis. Gastrointest Endosc, 1994, 40:442-446.
8. Catalano MF, Alcocer E, Chak A, et al. Evaluation of metastatic celiac axis lymph nodes in patients with esophageal carcinoma: accuracy of EUS. Gastrointest Endosc, 1999, 50:352-356.
9. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clinical Radiology,2004, 59:26-38.
10. Jin Z, Li X, Cai L. Assessing the resectability of pancreatic ductal adenocarcinoma: comparision of dual-phase helical CT arterial portography with conventional angiography. Chin Med Sci J. 2001 Mar; 16: 40-45.
11．林国为，沈福民．现代临床流行病学．上海医科大学出版社，第1版，2000：56-58．
12. NakayamaY, yamashita Y, Kadota M, et al. Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assist Tomogr, 2001, 25: 337-342.
13. Sironi S, De Cobilli F, Zerbi A, et al. Pancreatic carcinoma: MR assessment of tumor invasion of the peripanceatic vessels. J Comput Assist Tomogr, 1995, 19: 739-744.
14. Kahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. Hepato-Gastroenterology, 2000, 47: 545-549.
15. House MG, Yeo CJ, Cameron JL, Predicting resectability of periampullary cancer with three-dimensional computed tomography. J Gastrointest Surg. 2004, 8: 280-288.
16. Scaglione M, Pinto A, Romano S, et al. Using multidetector row computed tomography to diagnose and stage pancreatic carcinoma: the problems and the possibilities. JOP. 2005, 13; 6: 1-5
17. DeWitt J, Devereaux B, Chriswell M, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004, 16; 141: 753-763.
18. Grenacher L, Klauss M, Dukic L, et al. Diagnosis and staging of pancreatic carcinoma: MRI versus multislice-CT--a prospective study Rofo. 2004; 176: 1624-1633.19. Soriano A, Castells A, Ayuso C, et al. Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography. Am J Gastroenterol. 2004, 99: 492-501.
20. Andre T, Balosso J, Louvet C, et al. Adenocarcinoma of the pancreas. Diagnosis and evaluation. Presse Med, 1998, 27: 537-538.
21. Reddy KR, Levi J, Livingstone A, Jeffers L, et al. Experience with staging laparoscopy in pancreatic malignancy. Gastrointest Endosc 1999, 49: 498-503.
22. Razak H, Ladny JR, Laszkiewicz J, et al. Diagnosis and surgical treatment of pancreatic carcinoma. Wiad Lek, 1999, 52: 480-487.
23. Takeuchi M, Kondo S, Surgiura H, et al. Preoperative predictors of short-term survival after pancteatic cancer resection. Hepatogastroenterology, 1998, 45: 2399-2403.
24. Rosch T, Schusdziarra V, Born P, et al. Modern imaging methods versus clinical assessment in the evaluation of hospital in-patients with suspected pancreatic disease. Am J Gastroenterol, 2000, 95: 2261-2270.
25. Bunk A, Pistorius S, Konopke R. The value of colour duplex sonography in the assessment of surgical resectability of pancreatic tumors. Ultraschall Med, 2001, 22: 265-273.
26. Yamao K, Okubo K, Sawaka A, et al. Endolumenal ultrasonography in the diagnosis of pancreatic diseases. Abdom Imaging, 2003, 28: 545-555.
27. Opacic M, Rustemovic N. Endoscopic ultrasonography and diagnostic algorithms in diseases of the gastrointestinal tract. Lijec Vjesn, 2003, 125: 192-199.28. Squilaci E, Fanucci E, Sciuto E, et al. Vascular involvement in pancreatic neoplasm a comparison between spiral CT and DSA. Digestive Diseases and Sciences, 2003, 48, 449-458.
29. Phoa SSKS, Reeders WA, Stoker J, et al. CT criteria for venous invasion in patients with pancreatic head carcinoma. Br J Radiol, 2000; 73: 1159-1164.
30. Freeny PC, traverso LW, Ryan JA. Diagnosis and staging of pancreatic adenocarcinoma with dynamic computed tomography. Am J Surg, 1993, 165: 600-606.
31. Loyer EM, davad CL, dubrow RA, et al. Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT. Abdom Imaging, 1996; 21: 202-206.
32. Vails c, Andia E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR, 2002; 178: 821-826.
33. Brugel M, Rummeny EJ, Dobritz M. Vascular invasion in pancreatic cancer: value of multislice helical CT. Abdom Imaging, 2004, 9: 239-245.
34. Huang QJ, Xu Q, Wang XN, et al. Hepatobiliary Pancreat Dis Int. 2002, 1: 614-619.
35. Minniti S, Bruno C, Biasiutti C, et al. Sonography versus helical CT in identification and staging of pancreatic ductal adenocarcinoma. Journal of Ultrosound, 2003, 31: 175-182.
36. Morrin MM, Kruskal JB, Raptopoulos V, et al. State of the art US is as accurate as helical CT angiography for detecting unresectable periampullary carcinoma. Ultrasound Med, 2001, 20: 481-490.
37. Vargas R, Nino-Murcia M, Trueblood W, et al. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations.??AJR Am J Roentgenol. 2004, 182:419-425.
38. Martin EO, Giles WL, Bradford JW, et al. Adenocarcinoma of the head of the pancreas: determination of surgical unresectability with thin section pancreatic phase helical CT. AJR, 1999, 173:1513-1518.
39. Alec JM, Xiao HZ, Heidrun R, et al. Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of respectability2report of the radiology diagnositic oncology group. Radiology, 1995, 195:327-332.
40. Taiji N, Yasuyuki Y, Yasuko A, et al. Local extension of pancreatic carcinoma: assessment with thin2section helical CT versus with breath2hold fast MR imaging2ROC analysis. Radiology,1999, 212: 445-452.
41. Maria BS, Janice WJ, Ashley G, et al. Dynamic contrast2enhanced MR imaging and dual2phase helical CT in the preoperative assessment of suspected pancreatic cancer: a comparative study with receiver operating characteristic analysis.AJR, 999, 173:583-590.
42. Bennett GL, Hann LE. Pancreatic ultrasonography. Surg Clin North Am, 2001, 81:259-283.
43. Roche CJ, Hughes ML, Garvey CJ, et al. CT and pathologic assessment of prospective nodal staging in patientswith ductal adenocarcinoma of the head of the pancreas. Am J Roentgenol 2003,180: 475-480.
44. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging. 2003,28:556-562.
45. Durbin TE, Chang KJ. Endoscopic ultrasound (EUS)criteria for predicting malignant lymph nodes using linear array and radialscans: Correlation with EUS-guided fine needle aspiration(FNA). Gastrointest Endosc 1996; 43:A5109(abstract).
46. Eloubeidi MA, Jhala D, Chhieng DC, et al., Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma. Cancer, 2003,99:285-292.
47. Varshney S, Hacking CN, Johnson CD. CT arterial portography in staging pancreatic malignancy. Int J Pancreatol, 2000,28:61-67.
48. Bluemke DA, Cameron JL, Hruban RH, et al. Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology, 1995,197:381-385.
49. Grutzmann R, Bunk A, Kersting S, et al. Prospective evaluation of ultrasound and colour duplex imaging for the assessment of surgical resectability of pancreatic tumours. Langenbecks Arch Surg,2003, 388:392 - 400.
50. Benson MD, Gandhi MR. Ultrasound of the hepatobiliary-pancreatic system. World J Surg, 2000, 24:166 - 170.
51. Gandolfi L, Torresan F, Solmi L, et al. The role of ultrasound in biliary and pancreatic diseases. Eur J Ultrasound. 2003,16:141-159.
52. Soto JA, Barish MA, Yucel KE, et al. Pancreatic duct: MR cholangiopancreatography with a three-dimentional fast spin-echo technique. Radiology 1995,196:459-464.
53. Lomanto D, Pavone P, Laghi A, et al. Magnetic resonance cholangiopancreatography in the diagnosis of biliopancreatic diseases. Am J Surg 1997,174:33-38.
54. Miyazaki T, Yamashita Y, Tsuchigame T, et al. MR cholangiopancreatography using HASTE(half-Fourier acquisition single-shot turbo spin-echo) sequences. AJR 1996,166:1297-303.
55. Barish MA, Yucel KE, Soto JA, et al. MR cholangiopancreatography: Efficacy of three dimentional turbospinecho technique. AJR 1995, 165: 295-300.
56. Tamm E, Charnsangavej C. Pancreatic cancer: current concepts in imaging for diagnosis and staging. 2001, Cancer J, 7: 298-311.
57. Ishida H, Konno K, Hamashima Y. Assessment of resectability of pancreatic carcinoma by colour Doppler sonography. Abdom Imaging, 1999, 24: 295-298.
58. Carlo Catalano, Andrea Laghi, Francesco Fraioli, et al. Pancreatic carcinoma: the role of high-resolution multislice spiral CT in the diagnosis and assessment of resectability. Eur Radiol, 2003, 13: 149-156.
59. Shima W, Rugger R, Schober E, et al. Diagnosis and staging of pancteatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CT. AJR, 2002, 179: 717-724.
60. Diehl SJ, Lehmann KJ, Sadick M, et al. Pancreatic cancer: Value of dual-phase helical CT in assessing resectability. Radiology 1998, 206: 373-8.
61. Zeman RK, Cooper C, Zeiberg AS, et al. TNM staging of pancreatic carcinoma using helical CT. AJR 1997, 169: 459-64.
62. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging. 2003, 28: 556-562.
63. Calculli L, Casadei R, Amore B, et al. The usefulness of spiral Computed Tomography and colour-Doppler ultrasonography to predict portal-mesenteric trunk involvement in pancreatic cancer. Radiol Med(Torino). 2002, 104: 307-15.
64. Queneau PE, Sauve1 G, Koch1 S, et al. The Impact on Clinical Practice of Endoscopic Ultrasonography Used for the Diagnosis and Staging of Pancreatic Adenocarcinoma. J Pancreas, 2001, 2:??98-104.
65. Tierney WM, Francis IR, Eckhauser F, et al. The accuracy of EUS and helical CT in the assessment of vascular invasion by periampullary malignancy. Gastrointest Endosc, 2001,53:182-187.
66. Gabata T, Matsui O, Kadoya M, et al. smallpancreatic adenocarcinoma: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology,1994, 193:683-688.
67. Semelka RC, Kroeker MA, Shoenut JP, et al. pancreatic disease: prospective comparison of CT, ERCP, and 1.5 T MR imaging with dynamic gadolinium enhancement and fat suppression. Radiology, 1991,181:785-791.
68. Vellet AD, Romano W, Bach DB, et al. Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5T. Radiology, 1992, 183:87-95.
69. Sittek H, Heuck AF, Folsing C, et al. Static and dynamic MR tomography of the pancreas: contrast media kinetics of the normal pancreatic parenchyma in pancreatic carcinoma and chronic pancreatitis. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr, 1995, 162: 396-403.
70. Mirowitz SA, Gutierrez E, Lee JK, et al. Normal abdominal enhancement patters with dynamic gadolinium-enhanced MR imaging. Radiology, 1991,180:637-640.
71. Reiber A, Tomczak R, Nussle K, et al. MRI with mangafodipir trisodium in the detection of pancreatic tumours: comparison with helical CT. Br J Radiol, 2000, 73:1165-1169.
72. Fayad LM, Mitchell DG. Magnetic resonance imaging of pancreatic adenocarcinoma. 2001, lnt J Gastrointest Cancer 30:19 - 25.
73. Maire F, Sauvanet A, Trivin F, et al. Staging of pancreatic head adenocarcinoma with spiral CT and endoscopic ultrasonography:an indirect evaluation of the usefulness of laparoscopy. Pancreatology. 2004, 4:436-40.
74. Yusoff IF, Mendelson EM, Edmunds SEJ, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Adom Imaging, 2003, 28:556-562.
75. Arslan A, Buanes T, Geitung JT. Pancreatic carcinoma: MR, MR angiography and dynamic helical CT in the evaluation of vascular invasion. Eur J Radiol, 2001,38:151-159.
76. akahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. Hepatogastroenterology, 2000, 47: 545 - 549.
77. Nakeeb A, Lillemoe KD, Grosfeld JL. Surgical techniques for pancreatic cancer. Minerva Chir. 2004,59:151-63.
78. Aramaki M, Matsumoto T, Etoh T, et al. Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma. Hepatogastroenterology. 2003, 50: 263 -266.
79. Richter A, Gaa J, Niedergethmann M, et al. Ultrafast magnetic resonance tomography changes the standard in pancreas diagnosis. Chirurg, 2001, 72:697 - 703.
80. Menack MJ, Spitz JD, Arregui ME. Staging of pancreatic and ampullary cancers for resectability using laparoscopy with laparoscopic ultrasound. Surg Endosc, 2001,15:1129 - 1134.
81. Barreiro CJ, Lillemoe KD, Koniaris LG, et al. Diagnostic laparoscopy for periampullary and pancreatic cancer: what is the true benefit? J Gastrointest Surg, 2002, 6:75 - 81.
82. Brooks AD, Mallis M, Brennan MF, et al. The value of laparoscopy in the management of ampullary, duodenal, and distal bile ducttumors. J Gastrointest Surg, 2002, 6: 139-146.
83. Barreiro CJ, Lillemoe KD, Koniaris LG, etal. Diagnostic Laparoscopy for Periampullary and Pancreatic Cancer: What Is the True Benefit? J Gastrointest Surg, 2002, 6: 75-81.
84. Domagk D, Poremba C, Dietl KH, et al. Endoscopic transpapillary biopsies and intraductal ultrasonography in the diagnostics of bile duct strictures: a prospective study. 2002, Gut 51: 240-244.
85. Velanovich V. The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer. Surg Endosc. 2004, 18: 310-313.1. Lindell G, Borch K, Tingstedt B,et al. Management of cancer of the ampulla of Vater: does local resection play a role? Dig Surg, 2003, 20:511-515.
2. Kimura W, Futakawa N, Zhao B. Neoplastic diseases of the papilla of Vater. J Hepatobiliary Pancreat Surg, 2004, 11:223-231.
3. Zhou H, Schaefer N, Wolff M, et al. Carcinoma of the ampulla of Vater: comparative histologic/immunohistochemical classification and follow-up. Am J Surg Pathol, 2004, 28:875-882.
4. Wang LF, Hingorani SR, Tuveson DA. et al. Detecting and diagnosing ampullary neoplasms. Cancer Biol Ther, 2004, 3: 657 - 659.
5. Beger HG, Thorab FC, Liu Z, et al. Pathogenesis and treatment of neoplastic diseases of the papilla of Vater: Kausch-Whipple procedure with lymph node dissection in cancer of the papilla of Vater. J Hepatobiliary Pancreat Surg,2004, 11:232-238.
6. Duffy JP, Hines OJ, Liu JH, et al. Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections. Arch Surg, 2003, 138:941-948.
7. Todoroki T, Koike N, Morishita Y, et al. Patterns and predictors of failure after curative resections of carcinoma of the ampulla of Vater. Ann Surg Oncol, 2003,10:1176-1183.
8. Schwarz RE, Smith DD, Keny H. Impact of intraoperative radiation on postoperative and disease-specific outcome after pancreatoduodenectomy for adenocarcinoma: a propensity score analysis. Am J Clin Oncol,2003, 26:16-21.
9 Nakano K, Chijiiwa K, Toyonaga T, et al. Combination therapy of resection and intraoperative radiation for patients with carcinomas ofextrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone? Hepatogastroenterology, 2003, 50: 928-933.
10. Wiedmann M, Schoppmeyer K, Witzigmann H, et al. [Current diagnostics and therapy for carcinomas of the biliary tree and gallbladder. Z Gastroenterol, 2005, 43:305-315.
11. Wang CH, Mo LR, Lin RC, et al. A survival predictive model in patients undergoing radical resection of ampullary adenocarcinoma. Hepatogastroenterology,2004,51:1495-1499.
12. Hidekazu M et al. Evaluation of endoscopic ultrasonography in the diagnosis of cancer of the papilla of vater. Gastroenterol Endosc, 1990, 32:355
13. Andersen HB, Pihl HE, Tjalve E, Burcharth F. CT diagnosis of pancreatic or periampullary cancer. Ugeskr Laeger 1994; 156: 7534-7537.
14. Kim JH, Kim MJ, Chung JJ, et al. Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics, 2002, 22:1335-1352.
15. AI-Mofleh IA, AI-Rashed RS, AI-Amri SM, et al. Malignant biliary strictures. Diagnosis and management. Saudi Med J, 2003,24:1360-3.
16. Vaishali MD, Agarwal AK, Upadhyaya DN, et al. Magnetic resonance cholangiopancreatography in obstructive jaundice. J Clin Gastroenterol, 2004, 38:887-90.
17. Schwartz LH, Lefkowitz RA, Panicek DM. et al. Breath-hold magnetic resonance cholangiopancreatography in the evaluation of malignant pancreaticobiliary obstruction. J Comput Assist Tomogr, 2003, 27:307-314.
18. Skordilis P, Mouzas IA, Dimoulios PD, et al. Is endosonography an effective method for detection and local staging of the ampullary carcinoma? A prospective study. BMC Surg, 2002, 2:1-5.
19. Yasuda K, Mukai H, Fujimoto S, et al. The diagnosis of pancreaticcancer by endoscopic ultrosonography. Gastrointestinal Endosc, 1988, 34:1.
20. Sivak MVK, Aufman A. Endoscopic ultrosonography in the differential diagnosis of pancreatic diagnosis. Scand J Gastroenterol, 1986, 123(Suppl): 130-135.
21. Tio TL, Tytgat GN. Endoscopic ultrasonography of normal and of pathologic upper gastrointestinal wall structure. Scand J Gastroenterol, 1986,123(Suppl):27-31.
22. Quirk DM, Rattner DW, Fernandez-del Castillo C, Warshaw AL, Brugge WR. The use of endoscopic ultrasonography to reduce the cost of treating ampullary tumors. Gastrointest Endosc 1997;46: 334-347.
23. Jarufe NP, Coldham C, Mayer AD, et al. Favourable prognostic factors in a large UK experience of adenocarcinoma of the head of the pancreas and periampullary region. Dig Surg,2004; 21:202-209.
24. Martin JA, Haber GB. Ampullary adenoma: clinical manifestations, diagnosis, and treatment. Gastrointest Endosc Clin N Am, 2003, 13:649-669.
25. Paramythiotis D, Kleeff J, Wirtz M, et al. Still any role for transduodenal local excision in tumors of the papilla of Vater? J Hepatobiliary Pancreat Surg, 2004, 11:239-44.
26. Sherlock, SH.; Dooley, J. Disease of the liver and biliary system.9.London: Blackwell scientific publications.;1993. Disease of the Ampulla of Vater and Pancreas, P.599-605.
27. Sellner FJ, Riegler FM, Machacek E. Implications of histological grade of tumour for the prognosis of radically resected periampullary adenocarcinoma. Eur J Surg, 1999,165: 865-870.
28. Yasuda K, Mukai H, Fujimoto S, et al. The diagnosis of pancreatic cancer by endoscopic ultrosonography. Gastrointestinal Endosc,1988, 34: 1-5.
29. Sivak MVK, Aufman A. Endoscopic ultrosonography in the differential diagnosis of pancreatic diagnosis. Scand J Gastroenterol, 1986, 123 (Suppl): 130-136.
30. Schwarz M, Pauls S, Sokianski R, et al. Is a peroperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective? Am J Surg, 2001, 182: 243-249.1. Wang L, Yang GH, Lu XH, et al. Pancreatic cancer mortality in China(1991-2000). World J Gastroenterol, 2003, 9: 1819-1823
2. Jemal A, Tiwari RC, Murray T, et al. Cancer statistics, 2004. CA Cancer J Clin, 2004, 54: 8-29.
3. NakayamaY, yamashita Y, Kadota M, et al. Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assist Tomogr, 2001, 25: 337-342.
4. Sironi S, De Cobilli F, Zerbi A, et al. Pancreatic carcinoma: MR assessment of tumor invasion of the peripanceatic vessels. J Comput Assist Tomogr, 1995, 19: 739-44.
5. Warshaw AL, Gu ZY, wittenberg J, et al. Preoperative staging and assessment of resectability of pancreatic cancer. Arch surg, 1990, 125: 230-3.
6. Warshaw AL, Fernandez-del Castillo C. Pancreatic carcinoma. N Engl J Med, 1992; 326: 455-65.
7. Takahashi S, Ogata Y, Aiura K, et al. Combined resection of the portal vein for pancreatic cancer: preoperative diagnosis of invasion by portography and prognosis. HepatoGastroenterology, 2000, 47: 545-549.
8. Aramaki M, Matsumoto T, Etoh T, et al. Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma. Hepatogastroenterology. 2003; 50: 263-266.9. Park DI, Lee JK, Kim JE, et al. The analysis of resectabilty and survival in pancreatic cancer patients with vascular invasion. J Clin Gastroenterol, 2001, 32:231-234.
10. Howard TJ, Chin AC, Streib EW, et al. Value of helical computed tomography, angiography, and endoscopic ultrasound in determining resectability of periampullary carcinoma. Am J Surg, 1997,174:237-241.
11. Tierney WM, Francis IR, Eckhauser F, et al. The accuracy of EUS and helical CT in the assessment of vascular invasion by peripapillary malignancy. Gastrointest Endosc, 2001, 53:182-188.
12. Tierney WM, Fendrick AM, Hirth RA, et al. The clinical and economic impact of endoscopic ultrosound in the staging of pancreatic cancer. Am J Gastroenterol, 2000, 95:1708-1713.
13. Tierney WA, Hirth RA, Fendrick AM, Scheiman JM. The clinical and economic impact of endoscopic ultrasound, MRA, and helical CT in the staging of pancreatic cancer. Gastrointrrointest Endosc 1997;15:81-89.
14. Bennett GL, Hann LE. Pancreatic ultrasonography. Surg Clin North Am 2001, 81:259-283.
15. Grutzmann R, Bunk A, Kersting S, et al. Prospective evaluation of ultrasound and colour duplex imaging for the assessment of surgical resectability of pancreatic tumours. Langenbecks Arch Surg. 2003; 388:392-400.
16. Minniti S, Bruno C, Biasiutti C, et al. Sonography versus helical CT in identification and staging of pancreatic ductal adenocarcinoma. J Clin Ultrasound, 2003;31:175-182.
17. Shams J, Stein A, Cooperman AM. Computed tomography for pancreatic diseases. Surg Clin of North Am, 2001, 81:283-306.
18. Scaglione M, Pinto A, Romano S, et al. Using multidetector rowcomputed tomography to diagnose and stage pancreatic carcinoma: the problems and the possibilities. JOP, 2005,13; 1-5.
19. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clin Radiol. 2004;59:26-38.
20. Bluemke DA, Cameron JL, Hruban RH, et al. Potentially resectable pancreatic adenocarcinoma: Spiral CT assessment with surgical and pathologic correlation. Radiology 1995; 197:381-385.
21. Megibow AJ, Zhou XH, Rotterdam H, et al. Pancreatic adenocarcinoma. CT versus MR imaging in the evaluation of resectability. Radiology Diagnotic Oncology Group. Radiology 1995;195:327-332.
22. McCarthy MJ, Evans J, Sagar G et al. Prediction of resectability of pancreatic malignancy by computed tomography. Br J Surg 1998;85:320-325.
23. Tio TL, Tytgat GNJ, Cikot RGLM, et al. Ampullopancreatic carcinoma: preoperatice TNM classification with endosonography. Radiology. 1990;175:455-461.
24. Rosch T, Braig C, Gain T, et a.Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography: comparison with convention sonography, computed tomography, and angiography. Gastroenterology. 1992,102: 188-199.
25. Dupuy DE, Costello P, Ecker CP. Spiral CT of the pancreas. Radiology 1992,183: 815-8.
26. Lu DS, Vedantham S, Krasny RM, et al. Two-phase helical CT for pancreatic tumors: Pancreatic versus hepatic phase enhancement of tumor, pancreas. And vascular structure. Radiology, 1996, 199: 697-701.
27. Lu DS, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer: Criteria for unresectability of major vessels as revealed bypancreatic-phase, thin-section hecal CT. A JR 1997, 168: 1439-1443.
28. Boland GW, O'Malley ME, Saez M, et al. Pancreatic-phase versus portal vein-phase helical CT of the pancreas: Optimal temporal window for evaluation of pancreatic adenocarcinoma. AJR, 1999, 172: 605-608.
29. Zeman RK, Cooper C, Zeiberg AS, et al. TNM staging of pancreatic carcinoma using helical CT. AJR 1997, 169: 459-464.
30. Diehl SJ, Lehmann KJ, Sadick M, et al. Pancreatic cancer: Value of dual-phase helical CT in assessing resectability. Radiology 1998, 206: 373-378.
31. Vedantham S, Lu DSK, Reber HA, et al. Small peripancreatic veins: improved assessment in pancreatic cancer patients using thin-section pancreatic phase helical CT. AJR, 1998, 170: 377-383.
32. Loyer EM, davad CL, dubrow RA, et al. Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT. Abdom Imaging, 1996; 21: 202-206.
33. valls c, Andia E, Sanchez A, et al. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR, 2002; 178: 821-826.
34. Brugel M, Rummeny EJ, Dobritz M. Vascular invasion in pancreatic cancer: value of multislice helical CT. Abdom Imaging. 2004; 29: 239-245.
35. Vargas R, Nino-Murcia M, Trueblood W, etal. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol. 2004; 182: 419-425.
36. House MG, Yeo CJ, Cameron JL, et al. Predicting resectability of periampullary cancer with three-dimensional computed tomography. J Gastrointest Surg. 2004; 8: 280-288.37. varshney S, hacking CN, Johnson CD. CT arterial portography in the staging of pancreatic maligmency. International journal of pancreatology, 2000;28:61-67.
38. Raptopoulos V, steer ML, Sheiman RG, et al. The use helical CT and CT angiography to predict vascular involvement from pancreatic cancer: correlation with findings at surgery. AJR, 1997, 168:971
39. Squillaci E, Fanucci E, Sciuto F, et al. Vascular involvement in pancreatic neoplasm: a comparison between spiral CT and DSA. Dig Dis Sci, 2003; 48:449-458.
40. Menack MJ, Spitz JD, Arregui ME. Staging of pancreatic and ampullary cancers for resectability using laparoscopy with laparoscopic ultrasound. Surg Endosc, 2001, 15:1129-134.
41. Launois B, stasik C, bardaxoglou E, et al. Who benefits from portal vein resection during pancreaticoduodenectomy for pancreatic cancer? World J Surg, 1999,23:926-929.
42. Ishiguchi T, Ota T, Naganawa S, CT and MR imaging of pancreatic cancer. Hepatogastroenterology. 2001; 48:923-7.
43. Murakami K, Nawano S, Moriyama N, et al. Usefulness of magnetic resonance imaging with dynamic contrast enhancement and fat suppression in detecting a pancreatic tumor. Jpn J Clin Oncol, 1998,28:107-111.
44. Ichikawan T, Haradome H, Hachiya J, et al. Pancreatic ductal adenocarcinoma: Preoperative assessment with helical CT versus dynamic MR imaging. Radiology 1997,202:655-662.
45. Irie H, Honda H, Kaneko K, et al. Compariaon od helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma. Abdomin Imag 1997,22:429-433.
46. Taylor AM, Roberts SA, Manson JM. Experience with laparoscopicultrasonography for defining tumour resectability in carcinoma of the pancreatic head and periampullary region. Br J Surg, 2001, 88, 1077-1083.
47. Sadick M, Diehl SJ, Lehmann KJ, et al. Evaluation of breath-hold contrast-enhanced 3D magnetic resonance angiography technique for imaging visceral abdomonal arteries and veins. Invest Radiol 2000, 35: 111-117.
48. Grenacher L, Klauss M, Dukic L, et al. Diagnosis and staging of pancreatic carcinoma: MRI versus multislice-CT--a prospective study. Rofo. 2004, 176: 1624-1633.
49. Reihoid C, Bret PM. Current status of MR cholangiopancreatography. AJR 1996; 166; 1285-1295.
50. Soto JA, Barish MA, Yucel KE, et al. Pancreatic duct: MR cholangiopancreatography with a three-dimentional fast spin-echo technique. Radiology 1995, 196: 459-464.
51. Lomanto D, Pavone P, Laghi A, et al. Magnetic resonance cholangiopancreatography in the diagnosis of biliopancreatic diseases. Am J Surg 1997, 174: 33-38.
52. Miyazaki T, Yamashita Y, Tsuchigame T, et al. MR cholangiopancreatography using HASTE(half-Fourier acquisition single-shot turbo spin-echo) sequences. AJR 1996, 166: 1297-303.
53. Barish MA, Yucel KE, Soto JA, et al. MR cholangiopancreatography: Efficacy of three dimentional turbo spinecho technique. AJR 1995, 165: 295-300.
54. lorenz M, Heinrich S, Staib-Sebler E, et al. Regional chemotherapy in the treatment of advanced pancreatic cancer-is it relevant? Eur J Cancer, 2000, 36: 957-965.
55. Ahmad NA, Kochman ML, Lewis JD, et al. Endosonography is superior to angiography in the preoperative assessment of vascular??involvement among patients with pancreatic carcinoma. J Clin Gastroenterol, 2001,32:54-58.
56. Sladinger PF, et al. J Gastrointest Surg, 2000, 4(3):233-237.
57. Heertum RLV, Fawwaz RA. The role of nuclear medicine in the evaluation of pancreatic disease. Surgical Clinics of North America, 2001,81(2):345-358.
58. Nakata B, Nishimura S, Ishikawa T, et al. Prognostic predictive value of _(18)F-fluorodeoxyglucose positron emission tomography for patients with pancreatic cancer. Int J oncol, 2001, 19:53-58.
59. Yusoff IF, Mendelson RM, Edmunds SE, et al. Preoperative assessment of pancreatic malignancy using endoscopic ultrasound. Abdom Imaging, 2003; 28:556-562.
60. Palazzo L, Roseau G, Gayet B, et al. Endoscopic ultrsonography in the diagnosis and staging of pancreatic adenocarcinoma: Results of a prospective study with comparison to ultrasonography and CT scan. Endoscopy 1993,25:143-150.
61. Bhuani MS. Endoscopic ultrasound in pancreatic diseases indications, limitations, and the future. Gastroenterology Clinic of North America, 1999, 28:747-770.
62. Lok Tio T, Hoei Sie L, Kallimanis G, et al. Staging of ampullary and pancreatic carcinoma: Comparson between endosonography and surgery. Gastrointest Endosc 1996,44:706-713.
63. Yasuda K, Mukai H, Nakajima M, et al. Staging of pancreatic carcinoma by endoscopic ultrasonography. Endoscopy 1993, 25:151-5.
64. Rosch T, Lorenz R, Braig C, et al. Endoscopic ultrasonography in diagnosis and staging of pancreatic and biliary tumors. Endoscopy 1992; 24(suppl 1): 304-308.
65. DeWitt J, Devereaux B, Chriswell M, et al. Comparison ofendoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004, 141: 753-63.
66．田艳涛，赵平，王成峰，等．内镜超声检查对胰腺癌可切除性的评估．中华消化内镜杂志，2004，21：232-234．
67. SnadyH, BrucknerH, SiegelJ, etal. Endoscopic ultrasono-graphic criteria of vascular invasion by potentially respectable pancreatic tumors. Gastrointest Endosc, 1994, 40: 326.
68. tio TL, Tytgat GN. Endoscopic ultrasonography in staging local respectability of pancreatic and periaampullary malignandy. Scand J Gastroenterol, 1986, (Suppl): 135.
69. Durbin TE, Chang KJ. Endoscopic ultrasound (EUS)criteria for predicting malignant lymph nodes using linear array and radial scans: Correlation with EUS-guided fine needle aspiration(FNA). Gastrointest Endosc 1996; 43: A5109(abstract).
70. Chang KJ, Katz KD, Durbin TE, et al. Endoscopic ultrasound-guided fine-needle aspiration. Gasteointesrt Endosc 1994, 40: 694-700.
71. Schwarz M, Pauls S, Sokianski R, et al. Is a peroperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective? Am J Surg, 2001, 18, 182: 234-249.
72. Rodriguez J, Kasberg C, Nipper M, et al. CT-guided needle biopsy of the pancreas. A retrospective analysis of diagnostic accuracy. Am J Gastroenterol 1992, 87: 1601-1603
73. Pinto MM, Avila NA, Criscuolo EM. Fine needle aspiration of the pancreas: Five year experience. Acta Cytol 1988, 32: 39-42.
74. Chang KJ, Wiersema M, et al. Multi-center collaborative study on endoscopic ultrasound(eusOguided fine needle aspiration (FNA) of??the pancreas. Gastrointest Endosc 1996, 43:A507(abstract).
75. Ryan ME. Cytologic brushings of ductal lesions during ERCP. Gastrointest Endosc 1991,37:139-142.
76. Ferrari A, Lichtenstein D, Slivka A, et al. Brush cytology during ERCP for the diagnosis of biliary and pancreatic malignancies. Gastrointest Endosc, 1994, 40:140-145.
77. Chang K, Nguyen P. Erickson RA, et al. The clinical utility of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) on the diagnisis and staging of pancreatic carcinoma. Gastrointest Endosc 1997,45:387-393.
78. Wiersema MJ. Identifying contraindications to resection in patients with pancreatic carcinoma: the role of endoscopic ultrasound. Can J Gastroenterol. 2002; 16:109-114.
79. Legmann P, Vignaux O, Dousset B, et al. Pancreatic tumors: Comparison of dual-phase helical CT and enloscopic sonography. AJR 1998,170:1315-1322.
80. L(?)vy P, Boudet MJ, Zins M, et al. Preoperative nonresectability criteria used for pancreatic head adenocarcinoma: a practical survey among gastroenterologists and surgeons. Pancreas, 2000,21(4): 333-337.
81. Maire F, Sauvanet A, Trivin F, et al. Staging of pancreatic head adenocarcinoma with spiral CT and endoscopic ultrasonography: an indirect evaluation of the usefulness of laparoscopy. Pancreatology. 2004;4:436-440.
82. Velanovich V. The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer. Surg Endosc. 2004;18:310-313.
83. Tada M, Omata M, kawai S, et al. Detaction of ras gene mutations in pancreatic juice and peripheral blood of patients with pancreaticadenocarcinoma. Cancer Res, 1993,53:2472-2474.
84. Mohiuddin M, ahmed MM, Venkatasubbarao K. c-Ki-ras mutation in peripherial blood of pancreatic cancer patients: A marker for early tumor metastasis. Int J Radiat Oncol Biol Phys 1996,34:161-166.
85. Izbicki JR, Hosch SB, pichlmeier U, et al. Prognostic value of immunohistochemically identifiable tumor cells in lymph nodes of patients with completely resected esophageal cancer. N Engl J Med, 1997,337:1188-1194.
86. Schott A, vogel I, Krueger U, et al. Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker. Ann Surg, 1998, 227:372-379.
87. Jauch KW, Heiss MW, Gruetzner U, et al. Prognostic significence of bone marrow micrometastases in patients with gastric cancer. J Clin Oncol, 1996,14:1810-1817.
88. Diel IJ, Kaufmann M, Costa SD, et al. Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comprison with nodal status. J Natl cancer Inst, 1996,88:1652-1658.
89. Z'graggen K, Centeno BA, Castillo CF, et al. Biological implications of tumor cells in blood and bone marrow of pancreatic cancer patients. Sugery, 2001, 129(5):537-546.
90. Makary MA, warshaw AL, centeno BA, et al. Implications of peritoneal cytology for pancreatic cancer management. Arch Surg, 1998,133:361-365.
91. Schmidt J, Fraunhofer S, Fleisch M, et al. Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma? Hepatogastroenterology. 2004;:1827-1831.
92. Schlieman MG, Ho HS, Bold RJ. Utility of tumor markers in determining respectability of pancreatic cancer. Arch Surg, 2003, 138: 951-956.
93. He YC, Peng W, Qiao J, et al. Relationship between nuclear morphometry, DNA content and resectability of pancreatic cancer. World J Gastroenterol 2003; 9: 1863-1865.
94. Weger AR, Glaser KS, Schwab G, et al. Quantitative nuclear DNA content in fine needle aspirates of pancreatic cancer. Gut, 1991; 32: 325-328.
95. Joeusuu H, Alanen KA, Klemi PJ. Doubts on "curative" resection of pancreatic cancer. Lancet, 1989; 1: 953-954.
96. Williams DS, Sahai AV, Aabakken L, et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut, 1999; 44: 720-726.
97. Soriano A, Castells A, Ayuso C, et al. Preoperative Staging and Tumor Resectability Assessment of Pancreatic Cancer: Prospective Study Comparing Endoscopic Ultrasonography, Helical Computed Tomography, Magnetic Resonance Imaging, and Angiography. Am J Gastroenterol, 2004; 99: 492-501.
98. Elixhauser A, Halpern MT. Economic evaluations of gastric and pancreatic cancer. Hepatogastroenterology, 1999, 46: 1206-1213.
99. Mcmahon PM, Haalpern EF, Fernandez-del castillo C, et al. Pancreatic cancer: cost-effective of imaging technologies for assessing resectability. Radiology, 2001, 221: 93-106.
100．田艳涛，赵平．前瞻性评估胰腺癌可切除性研究进展．中国肿瘤临床与康复．2003，11：182-185．
101. Nakeeb A, Lillemoe KD, Grosfeld JL. Surgical techniques for pancreatic cancer. Minerva Chir. 2004; 59: 151-63.
102. House MG. Predicting resectability of periampullary cancer with??three-dimensional computed tomography. J Gastrointest Surg. 2004, 8:280-288.
103. Vargas R. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. Am J Roentgenol. 2004,182:419-425.
104. Smith SL, Rajan PS. Imaging of pancreatic adenocarcinoma with emphasis on multidetector CT. Clin Radiol, 2004, 59:26-30.