Combined pancreaticoduodenectomy and hepatectomy for patients with locally advanced gallbladder carcinoma

Shirai, Yoshio; Ohtani, Tetsuya; Tsukada, Kazuhiro; Hatakeyama, Katsuyoshi

doi:10.1002/(sici)1097-0142(19971115)80:10<1904::aid-cncr5>3.0.co;2-n

Cited by 84 publications

(55 citation statements)

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“…Table 3 shows the mortality rate worldwide. Shirai et al 25 reported a 5-year survival rate of 29% in patients with stage IVB gallbladder cancer undergoing HPD. The 5-year survival was 50% in R0 resection, in a group of 17 patients undergoing HPD.…”

Section: Resultsmentioning

confidence: 99%

“…7 In 1990´s Japanese reports with it, including Nimura´set al 2 initial series with 24 cases and 25% mortality, mainly by liver failure and sepsis. Shirai et al 25 reported seven HPDs with 29% mortality rate. Miyagawa et al 24 in 1996 published 0% mortality in seven cases and routine preoperative portal vein embolization.…”

Section: Discussionmentioning

confidence: 99%

“…Miyagawa et al 24 in 1996 published 0% mortality in seven cases and routine preoperative portal vein embolization. Shirai et al 25 in 1997 reported 17 cases in stage IV gallbladder cancer and the 5-years survival was 29% and those with R0 resection the 5-years survival was 50%. The authors learned from this series that HPD is a very complex operation and the combination of right lobectomy or right trisectionectomy has a high mortality rate and such procedures requires a mandatory portal vein embolization to ensure a liver remnant large enough to avoid liver dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Discussion of PD indications is still very controversial ( Figure 1). 18,24,25 However, advanced gallbladder carcinoma is associated with a high incidence of metastases to the hepatoduodenal ligament lymph nodes, posterior pancreatoduodenal lymph nodes, and the common hepatic artery. Table 2 resumes total indications of HPD in our series.…”

Section: -21mentioning

confidence: 99%

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Hepatopancreatoduodenectomy-Lesson’s with 35 Patients over 10 Years

Fernandes¹

2017

JLRDT

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AimHepatopancreatoduodenectomy (HPD) is the most complex abdominal surgery and performed in only a few groups in Brazil. Gallbladder cancer remains a reserved prognosis disease and in selected cases, radical resection (R0) surgery allows survival even in advanced tumors. Cholangiocarcinomas represent the main indication for HPD with promising results. IntroductionHepatopancreatoduodenectomy (HPD) represents the most complex abdominal operation comprising generally large resections of hepatic parenchyma combined with gastro-duodenum-pancreatectomy, in which its main indications include biliary tract neoplasia. Surgical resection is considered the only potential modality of cure in the treatment of malignant biliary tumors, including gallbladder cancer and cholangiocarcinomas. High morbidity and mortality rates still affect a large part of the patients submitted to this operation due to extensive resections of hepatic parenchyma associated with critical anastomoses of bile ducts and pancreatic gland. 1-3Biliary carcinoma can be divided between gallbladder carcinoma and cholangiocarcinomas, since they have distinct biological behavior, probably because they have very different histological characteristics. Gallbladder carcinoma often mimics "pseudoklatskin" hilar cholangiocarcinomas. The rich submucosal layer of the gallbladder is connected to the large lymphatic chain of the hepatic and retroperitoneum wire, in addition to numerous cystic veins draining into the liver parenchyma. In this way, the carcinoma of the vesicle presents a more aggressive biological behavior, with distant metastatic potential. In contrast, cholangiocarcinomas present local and radial (superficial spread) infiltration and less frequent distant dissemination, probably due to their histology with scarce submucosal layer. Abstract Hepatopancreatoduodenectomy (HPD) represents the most complex abdominal operation comprising generally large resections of hepatic parenchyma combined with gastro-duodenum-pancreatectomy, in which its main indications include biliary tract neoplasia. Surgical resection is considered the only potential modality of cure in the treatment of malignant biliary tumors, including gallbladder cancer and cholangiocarcinomas. High morbidity and mortality rates still affect a large part of the patients submitted to this operation due to extensive resections of hepatic parenchyma associated with critical anastomoses of bile ducts and pancreatic gland.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: -21mentioning

confidence: 99%

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Hepatopancreatoduodenectomy-Lesson’s with 35 Patients over 10 Years

Fernandes¹

2017

JLRDT

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“…1,2 Although hepatopancreatoduodenectomy has been performed for advanced stage disease as an attempt at curative resection over the past three decades, only a few sporadic case reports or small patient series have been published and the surgical outcomes of the procedure have not been adequately analyzed. [3][4][5][6][7][8][9][10] The purpose of the present study was to perform a systematic review of the literature to evaluate the safety and efficacy of hepatopancreatoduodenectomy for BC and GC.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers

Zhou

Zhang

et al. 2015

HPB

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Objectives: To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.Methods: Medline and EMBASE were systematically searched for papers of hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers.Results: Eighteen studies involving 397 patients were reviewed. Major hepatectomy was undertaken in 81.3% of the 397 patients and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median = 31%).The 5-year survival rate in patients who underwent curative resection was 18-68.8% (median = 51.3%), and 0% in patients who received non-curative resection.Conclusions: Hepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom curative resection is feasible.

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