Faculty Collaboration Database

Intraoperative radiation therapy following pancreaticoduodenectomy. Ann Surg 1993 Jul;218(1):54-60

Date

07/01/1993

Pubmed ID

8101073

Pubmed Central ID

PMC1242900

DOI

10.1097/00000658-199307000-00009

Scopus ID

2-s2.0-0027177739 (requires institutional sign-in at Scopus site)   52 Citations

Abstract

OBJECTIVE: To determine the morbidity and mortality of pancreaticoduodenectomy followed by electron-beam intraoperative radiation therapy (EB-IORT).

SUMMARY BACKGROUND DATA: Local recurrence following pancreaticoduodenectomy occurs in 50% to 90% of patients who undergo a potentially curative surgical resection for adenocarcinoma of the pancreatic head. To improve local disease control, a more aggressive retroperitoneal dissection has been combined with adjuvant EB-IORT.

METHODS: Forty-one patients with malignant neoplasms of the periampullary region underwent pancreaticoduodenectomy followed by EB-IORT between January 1989 and May 1992. EB-IORT was delivered in a dedicated operative suite, eliminating the need for patient relocation. Electron-beam energies of 6 to 12 MeV were used to deliver 10 to 20 Gy to the treatment field following resection but before pancreatic, biliary, and gastrointestinal reconstruction.

RESULTS: Median operative time was 9 hours, blood loss was 1 L, perioperative transfusion requirement was 2 units, and hospital stay was 20 days. One patient died of a postoperative myocardial infarction, and four patients required reoperation, one for an anastomotic leak. No patient failed to receive EB-IORT because of operative complications during the time period of this study.

CONCLUSION: Adjuvant EB-IORT after pancreaticoduodenectomy can be delivered safely, with low mortality and acceptable morbidity.

Author List

Evans DB, Termuhlen PM, Byrd DR, Ames FC, Ochran TG, Rich TA

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adult
Aged
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Intraoperative Period
Male
Middle Aged
Pancreatic Neoplasms
Pancreaticoduodenectomy
Postoperative Complications
Radiography