Umar Amin, Rashed Nazir.
Role of MDCT in detecting patterns of recurrence after Whipple procedure in follow-up of pancreatic malignancy..
Pak J Radiol Jan ;24(2):41-4.

Objective: The aim of the study was to identify recurrent sites of pancreatic cancer on Multidetector CT (MDCT) in follow-up of pancreatic cancer surgery (Whipple procedure). Methodology: This was retrospective case series conducted in Radiology And Imaging Department, Shifa International Hospital, Islamabad from June 2010 to June 2013. Total 42 patients were recruited who underwent CT for follow-up of tumor recurrence after Whipple procedure for pancreatic malignancy from June 2010 to June 2013. Their CT reports were reviewed and sites of recurrence were evaluated.   Results: Out of 42 patients, 33 (67.65%) were male and 9 (32.35%). Age ranged from 18 to 70 years with mean age of years. Mean follow up period ranged from 5 to 26 months. Tumor recurrence was seen in 32 patients. Local recurrence was the most common type of recurrence, (n=21 cases %) followed by combined local, hepatic and nodal recurrence (n= 9).  Superior mesenteric artery (SMA) was the most common vessel involved in local recurrence 80%, either alone (56%) or in combination with other vessels, superior mesenteric vein (SMV), splenic vein, portal vein or celiac trunk. Tumor marker CA 19-9 was raised in all the patients with a range of 80 to 600. Conclusion: Multidetector CT performed with standard protocol in follow up of patients after Whipple procedure is an optimal method for detecting tumor recurrence. Local recurrence alone or in combination with metastatic disease in nodes and liver is seen in most cases. Low Incidence of isolated lung and hepatic recurrence was seen in post–Whipple follow up. . Key Words: Multidetector CT angiography, Whipple, Recurrence.

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