Real-time and the in vivo detection of minute cancer invasion to the portal-superior mesenteric vein using contact endoscopy during a pancreatic cancer resection.
The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wall can be obtained in vivo, was used during pancreatic cancer resections. Contact endoscopy succeeded in detecting minute cancer invasion and identified the precise location on the isolated PV/SMV wall in 3 out of 11 patients whose PV/SMVs had been disclosed from the pancreatic tumors. The 3 positive patients underwent an additional resection of the PV/SMV, and appropriate ranges of PV/SMV resection were confirmed by the postoperative histology. Thus, contact endoscopy is considered a promising modality for making a real-time diagnosis on the precise location of minute cancer, without requiring any tissue sampling.
Eguchi
Hidetoshi
H
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan. hidetoshi-eguchi@nifty.com
Ishikawa
Osamu
O
Ohigashi
Hiroaki
H
Takahashi
Hidenori
H
Ohue
Masayuki
M
Takenaka
Akemi
A
Tomita
Yasuhiko
Y
Yano
Masahiko
M
D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology* / Q000601:surgery*; D003199:Computer Systems; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011169:Portal Vein / Q000473:pathology*