Usage of fibrin-based sealants in distal pancreatectomy

Abstract

Aims: We present a new method for pancreatic sentinel node (SN) detection with gamma probe. Patients & methods: Seven patients with cT2N0M0 pancreatic head cancer were enrolled between 2009 to 2012 to this exploratory study. One day prior to surgery, preoperative endoscopic intratumoral administration of Tc99m labeled nanocolloid followed by scintigraphy study 2 hours later was conducted. Peroperative gamma probe detection of SN was also performed. Results: Radiotracer administration was feasible in all patients. Scintigraphy study showed interaortocaval dissemination in 2 patients, hepatic contamination in 2 patients, colonic contamination in 4 patients and no activity in 1 patient. Intraoperative SN detectionwas accomplished in 2 patients, both with negative results. Only 4 pancreatic cancers could be resected and only1SNcouldbeconfirmedas truenegativebyfinalhistopathologic analysis. Conclusion: This newmethod of pancreatic SN detection is technically feasible but challenging. Results do not allow clinical validation.