Abstract
Background/Aims: Double duct sign, which is used to detect invasive cancer of the pancreatic head on endoscopic retrograde cholangiopancreatography (ERCP), is composed of co-strictures of the common bile and main pancreatic ducts. There have been no reports of the correlation between double duct sign and portal vein invasion.
Methods: We enrolled 105 patients with pancreatic head cancer undergoing ERCP before radical pancreatoduodenectomy in our department from 1986 to 2003, and studied the correlations between double duct sign and pathologic factors including portal vein invasion.
Results: Double duct sign significantly correlated with pathological invasion to the portal vein (P<0.001). In cancers of the pancreatic head which were double duct sign positive and had a tumor diameter of more than 2cm in CT scan, the diagnosis of portal vein invasion was made with the specificity of 76.9% and the positive predictive value of 72.7%. Double duct sign also significantly correlated with tumor size and perineural invasion (p<0.05).
Conclusion: Double duct sign may contribute to assess histologic portal vein invasion preoperatively, especially in combination with tumor size as measured by computed tomography and ultrasonography.
