Selective Vein Catheterization for Hormone Assay in Endocrine Tumours of the Pancreas

Abstract

Based on 45 examinations the technique of selective catheterization of the pancreatic veins for blood sampling using percutaneous transhepatic approach to the portal vein is described. The results are compared with the angiographic findings in 16 patients with islet cell tumours of islet cell hyperplasia.

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling

“…Although no side effects were encountered in our series, the following major complications are reported in the literature: large hematoma of the liver in 1 case, fever and pain following accidental puncture of the gallbladder in 1 case, bile leakage requiring cholecystostomy in 1 patient, intraabdominal bleeding requiring operative intervention in 1 patient, and mesenteric vein thrombosis in another [21,[28][29][30].…”

Hormone-Producing Tumours of the Gut

“…When arteriography fails, percutaneous transhepatic portal and pancreatic venous sampling with measure ment of peptide gradients may localize areas of high concentration [2,27], This method is however technically difficult and interpreta tion of data frought with problems because of the variability in pancreatic venous drainage and lack of information on normal peptide concentrations. Complications include perfo ration of the gall-bladder and hepatic haematomas; however, in experienced hands, this technique is a useful adjunct to arteriography [27].…”

Localization of neuroendocrjne tumors of the pancreas

“…Some authors have suggested that venous sampling along the splenic, superior mesenteric, and portal veins yields results comparable to the more selective sampling of the pancreatic veins, which is a more time consuming procedure [MI. However, the presence of laminar flow in the portal vein and its larger tributaries may produce false results [37], thus making nonselective venous sampling a less desirable procedure [41,43,45]. Sampling of the hepatic veins has no value for either the evaluation of the results of pancreatic venous sampling or the detection of hepatic metastases, for which angiography is a more sensitive method [37].…”