Article

Pancreatoduodenectomy using a no-touch isolation technique.

Department of Surgery, Kumamoto Regional Medical Center, 5-16-10 Honjo, Kumamoto City, Kumamoto 860-0811, Japan.
American journal of surgery (impact factor: 2.36). 01/2009; 199(5):e65-8. DOI:10.1016/j.amjsurg.2008.06.035 pp.e65-8
Source: PubMed

ABSTRACT Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. In an effort to overcome these problems, we have developed a surgical technique for no-touch pancreatoduodenectomy.
From March 2005 through May 2008, 42 patients have been operated on following this technique. Resected margins were microscopically analyzed.
We describe a technique for pancreatoduodenectomy using a no-touch isolation technique. We resect cancers with wrapping them within Gerota's fascia and transect the retroperitoneal margin along the right surface of the superior mesenteric artery and abdominal aorta without grasping tumors.
No-touch pancreatoduodenectomy has many potential advantages that merit further investigation in future randomized controlled trials.

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Keywords

42 patients
 
abdominal aorta
 
cancer cells
 
effective treatment
 
future randomized
 
Gerota's fascia
 
grasping tumors
 
no-touch isolation technique
 
no-touch pancreatoduodenectomy
 
peritoneal cavity
 
potential advantages
 
Resected margins
 
retroperitoneal margin
 
superior mesenteric artery
 
wrapping