Intraoperative irradiation in resected carcinoma of the pancreas and portal vein
M. Gotoh, M. Monden, M. Sakon, T. Kanai, K. Umeshita, H. Ikeda and T. Mori
Department of Surgery II, Osaka University Medical School, Japan.
We developed a new method that provides a wide retroperitoneal irradiation
field for patients with cancer of the pancreas in whom a long invaded
portal vein is resected during intraoperative radiotherapy. This method
involves the use of a venous bypass with a heparinized catheter that does
not require systemic anticoagulation or a pump. Anastomosis is completed
after intraoperative radiotherapy. Mean (+/- SD) duration of the venous
bypass was 3.0 +/- 1.5 hours (range, 2.0 to 6.6 hours), during which no
abnormalities of systemic blood pressure, heart rate, and
electrocardiographic activity and no signs of congestion of the intestines
were observed. Eleven patients were treated with this method, and no
complications ascribed to intraoperative radiotherapy or venous bypass were
found. We recommend this method as safe and simple for expanding the
irradiation field for intraoperative radiotherapy in patients with
pancreatic cancer in whom the portal vein is resected.
