S Kobayashi1, T Asano, T Ochiai. 1. Second Department of Surgery, Chiba University School of Medicine, 1-8-1 Inohana, Chuoh-ku, Chiba 260-8670, Japan. kobayasi@med.m.chiba-u.ac.jp
Abstract
BACKGROUND/AIMS: The procedure of pancreatoduodenectomy for periampullary cancers accompanies a risk to shed cancer cells into a portal vein while handling the pancreas head lesion. This manipulation may subsequently cause a liver metastasis. We devised the no-touch isolation technique for pancreatoduodenectomy without removing a portal vein, for the purpose of preventing the manipulated shedding of cancer cells into a portal vein and liver metastasis. METHODOLOGY: The fundamental procedure of this technique is that isolation of portal vein precedes the handling of tumor mass. Isolation of a portal vein is carried out with the ligature of its surrounding veins after dividing of duodenum and pancreas. We applied the no-touch isolation technique for 10 cases, which consisted of 6 cases of distal bile duct carcinoma and 4 cases of ampullary carcinoma, between May 1993 and July 2000. RESULTS: There was neither operative mortality nor liver metastasis cases in these cases. CONCLUSIONS: The no-touch isolation technique without removing a portal vein might be recommended as a safe and reasonable procedure for periampullary cancer patients who have the potential for subsequent liver metastasis.
BACKGROUND/AIMS: The procedure of pancreatoduodenectomy for periampullary cancers accompanies a risk to shed cancer cells into a portal vein while handling the pancreas head lesion. This manipulation may subsequently cause a liver metastasis. We devised the no-touch isolation technique for pancreatoduodenectomy without removing a portal vein, for the purpose of preventing the manipulated shedding of cancer cells into a portal vein and liver metastasis. METHODOLOGY: The fundamental procedure of this technique is that isolation of portal vein precedes the handling of tumor mass. Isolation of a portal vein is carried out with the ligature of its surrounding veins after dividing of duodenum and pancreas. We applied the no-touch isolation technique for 10 cases, which consisted of 6 cases of distal bile duct carcinoma and 4 cases of ampullary carcinoma, between May 1993 and July 2000. RESULTS: There was neither operative mortality nor liver metastasis cases in these cases. CONCLUSIONS: The no-touch isolation technique without removing a portal vein might be recommended as a safe and reasonable procedure for periampullary cancerpatients who have the potential for subsequent liver metastasis.