Biliodigestive Anastomosis After Intraoperative Irradiation in Swine

Abstract

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.

KEYWORDS:

• animal model
• bile duct
• biliodigestive anastomosis
• hepatobiliary surgery
• intraoperative irradiation
• IORT
• swine