Imperial College London
Mr Duncan Spalding

MrDuncanSpalding

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Hepato-Biliary Surgery
 
 
 
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Contact

 

+44 (0)20 3313 3941d.spalding

 
 
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Location

 

Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kumar:2018:10.18632/oncotarget.24596,
author = {Kumar, J and Reccia, I and Sodergren, MH and Kusano, T and Zanellato, A and Pai, M and Spalding, D and Zacharoulis, D and Habib, N},
doi = {10.18632/oncotarget.24596},
journal = {Oncotarget},
pages = {15732--15739},
title = {Radiofrequency assisted pancreaticoduodenectomy for palliative surgical resection of locally advanced pancreatic adenocarcinoma},
url = {http://dx.doi.org/10.18632/oncotarget.24596},
volume = {9},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Despite careful patient selection and preoperative investigations curative resection rate (R0) in pancreaticoduodenectomy ranges from 15% to 87%. Here we describe a new palliative approach for pancreaticoduodenectomy using a radiofrequency energy device to ablate tumor in situ in patients undergoing R1/R2 resections for locally advanced pancreatic ductal adenocarcinoma where vascular reconstruction was not feasible. Results: There was neither postoperative mortality nor significant morbidity. Each time the ablation lasted less than 15 minutes. Following radiofrequency ablation it was observed that the tumor remnant attached to the vessel had shrunk significantly. In four patients this allowed easier separation and dissection of the ablated tumor from the adherent vessel leading to R1 resection. In the other two patients, the ablated tumor did not separate from vessel due to true tumor invasion and patients had an R2 resection. The ablated remnant part of the tumor was left in situ. Conclusion: Whenever pancreaticoduodenectomy with R0 resection cannot be achieved, this new palliative procedure could be considered in order to facilitate resection and enable maximum destruction in remnant tumors. Method: Six patients with suspected tumor infiltration and where vascular reconstruction was not warranted underwent radiofrequency-assisted pancreaticoduodenectomy for locally advanced pancreatic ductal adenocarcinoma. Radiofrequency was applied across the tumor vertically 5-10 mm from the edge of the mesenteric and portal veins. Following ablation, the duodenum and the head of pancreas were removed after knife excision along the ablated line. The remaining ablated tissue was left in situ attached to the vessel.
AU  - Kumar,J
AU  - Reccia,I
AU  - Sodergren,MH
AU  - Kusano,T
AU  - Zanellato,A
AU  - Pai,M
AU  - Spalding,D
AU  - Zacharoulis,D
AU  - Habib,N
DO  - 10.18632/oncotarget.24596
EP  - 15739
PY  - 2018///
SN  - 1949-2553
SP  - 15732
TI  - Radiofrequency assisted pancreaticoduodenectomy for palliative surgical resection of locally advanced pancreatic adenocarcinoma
T2  - Oncotarget
UR  - http://dx.doi.org/10.18632/oncotarget.24596
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29644005
UR  - http://hdl.handle.net/10044/1/71855
VL  - 9
ER  -
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