This surgery enables the removal of complex tumors with significant venous involvement by using a temporary blood flow diversion technique. The procedure was made possible thanks to the prior creation of a three-dimensional model for advanced surgical planning.
For the first time in Spain, a team led by Dr. Juli Busquets, Head of the Surgery Section of the General and Digestive Surgery Service at the Bellvitge University Hospital, successfully performed on March 5 a surgical technique that allows for the removal of pancreatic tumours previously considered inoperable.
This technique—resection of pancreatic head cancer with intraoperative venous bypass—is characterized by the creation of a bypass between the vein that drains blood from the intestines and the vena cava before beginning the tumour resection. This diversion allows blood to continue circulating while the tumour is being removed, thereby preventing damage to the intestines and liver.
The procedure is useful in very specific cases where it is necessary to remove a pancreatic tumour that is attached to venous or arterial branches and cannot be excised without cutting them. These are known as locally advanced pancreatic cancers. Until now, most of these types of cancers were considered inoperable.
Dr. Busquets trained for this technique alongside Dr. Elena Rangelova from Sahlgrenska University Hospital in Gothenburg, a leading centre for this type of surgery. Also participating in the surgery were Dr. Montserrat Mallol from the Anesthesiology and Resuscitation Service, and Dr. Elena Iborra, Head of the Angiology and Vascular Surgery Service, among others. The operation proceeded without complications and was performed without the need for a blood transfusion. The patient was maintained on the bypass for 94 minutes. Once the tumour was removed, normal blood flow was restored.
The patient was a 45-year-old man with a pancreatic head tumour affecting the ileal, jejunal, and splenic veins, as well as other collateral venous branches. He was discharged on the 7th day post-surgery, with no postoperative complications. The tumour analysis confirmed a complete resection, validating the quality of the surgical procedure.
Three-dimensional model
The operation was made possible thanks to the prior creation of an advanced three-dimensional surgical planning model developed by Cella Medical Solutions. This model accurately reproduced the shape and position of the tumour, as well as the affected organs and vascular structures. The surgeon was able to study the tumour’s location in advance and determine the best surgical strategy to follow.
Bellvitge University Hospital is a reference center for pancreatic surgery, particularly for the resection of locally advanced pancreatic tumors—the most complex type of operable tumor due to their involvement with adjacent blood vessels. The Hepatobiliary and Pancreatic Surgery Unit, founded more than thirty years ago by the recently deceased Dr. Joan Fabregat, is a leading center for these complex interventions. It is currently the unit with the highest volume of pancreatic surgeries in Catalonia, with over 300 pancreatic resections in the past five years.
The hospital has also successfully implemented a robotic pancreatic surgery program, which increases surgical precision and allows for faster patient recovery. Another example of Bellvitge Hospital’s leadership role is Dr. Juli Busquets’ recent participation in the international Rediscover meeting to establish global consensus on the management of locally advanced and borderline resectable pancreatic cancer. Busquets was one of only two representatives from Spain involved in this consensus.