关键词: 开腹配合彩超引导, 125I粒子植入术, 晚期胰腺癌

Abstract: Objective To analyze the efficacy and complications of the treatment on advanced pancreatic cancer with color Doppler ultrasound-guided laparotomy for iodine125 implantation.Methods Retrospectively analyzed 16 patients with advanced pancreatic cancer.The radiation particles numbers were scheduled preoperatively by three-dimensional directional line treatment planning system (TPS).After abdominal exploration,the pancreatic cancer was confirmed by puncture biopsy.Color Doppler ultrasound-guided iodine125 interstitial brachytherapy was operated under direct vision.Taking abdominal incision to expose the pancreatic cancer,color Doppler ultrasound was used to determine the direction and scope of the needle,and the particle gun was used to implant particles.Attention was paid to protect blood vessels,pancreatic channel and gallbladder channel.There were 7 case of choledochoduodenostomy and 5 cases of gastrojejunostomy.Abdominal X or CT scan was performed two weeks later.Results 11 cases with pain symptom were completely or partially relieved.The effective time was 2-50 days,with a median onset time of 10 days.Reexamine at two weeks after operation showed that 1 case had two particles wandered into liver,2 cases had pancreatic fistula,3 cases had obstacle in gastric emptying.Conclusions The treatment of color Doppler ultrasound-guided laparotomy for iodine125 implantation on advanced pancreatic cancer has the advantages at accurate positioning,uniform particle arrangement,less complications and better analgesic effect.Some patients can have improved life quality and prolonged survival time after the treatment.

Key words: Color Doppler ultrasound-guided laparotomy, Iodine125 implant surgery, Advanced pancreatic cancer