Biliodigestive anastomosis after intraoperative irradiation in swine.
A large animal model was established to investigate the feasibility and suitable dosage of intraoperative radiation therapy (IORT) to the hepatic hilum before biliary-enteric anastomosis is performed. Twenty-two Pietrain Hampshire pigs underwent gallbladder and proximal bile duct resection followed by IORT using 20-40 Gy and performing biliary-enteric anastomosis. In the follow-up period of 56 days, pigs developed dose-dependent complications like stenosis of the biliary-enteric anastomosis. Results demonstrate that IORT of the liver hilum up to 20 Gy is safe with acceptable early complications in the presented animal model. The porcine biliary-enteric anastomosis can tolerate intraoperative irradiation up to a dosage of 40 Gy without disruption.
Kaiser
G M
GM
Department of General Surgery and Transplantation, University Hospital Essen, Essen, Germany. gernot.kaiser@uni-essen.de
Mueller
A B
AB
Sauerwein
W
W
Zhang
H W
HW
Westermann
S
S
Frühauf
N R
NR
Kuehne
C A
CA
Stuschke
M
M
Oldhafer
K J
KJ
Broelsch
C E
CE
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D000818:Animals; D001663:Bilirubin / Q000097:blood; D001918:Brachytherapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006500:Hepatic Duct, Common / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery*; D007430:Intraoperative Care; D007583:Jejunum / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery*; D008099:Liver / Q000201:enzymology; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000662:veterinary; D013552:Swine
D001663:Bilirubin