Tumor extension along percutaneous transhepatic biliary drainage tracts.

Percutaneous Transhepatic Biliary Catheterization is commonly employed in the diagnosis and management of obstructive jaundice associated with malignant lesions. Tumor manipulation as an effort to obtain a histological diagnosis or to establish short or long-term internal-external biliary drainage is liable to disseminate the malignancy along the catheter tract. Two cases of malignant seeding of the catheter tract after biliary drainage have been observed.

Detailed evaluation of angiographic findings in the surgical assessment of resectability for pancreatic cancer.

The role of angiography as a diagnostic approach and surgical assessment of resectability in pancreatic cancer patients is considered. Pre-operative arteriography of the celiac axis and superior mesenteric artery was performed in 27 patients with surgically proved pancreatic cancer. The operatibility of each patient was assessed according to arteriographic findings. The arteriographic features considered to establish tumor unresectability included: neoplastic arterial encasement or displacement, multiple involvement of pancreatic arteries, involvement of portal, splenic or superior mesenteric veins, liver metastasis. Nineteen angiographically predicted unresectable lesions proved to be unresectable at surgery. Of the eight additional patients who showed no remarkable unresectable angiographic features, 6 were confirmed resectable, while 2 were unresectable. Angiography was shown to be very accurate in differentiating resectable from unresectable cancer of the pancreas.