THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES
Background : Hepatopancreatoduodenectomy is one of the most complex abdominal operations mainly indicated in advanced biliary carcinoma. Aim : To present 10-year experience performing this operation in advanced malignant tumors. Methods : This is a retrospective descriptive study. From 2004 to 201...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2016-03-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000100017&tlng=pt |
| _version_ | 1818948682982096896 |
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| author | Eduardo de Souza Martins FERNANDES Felipe Tavares de MELLO Joaquim RIBEIRO-FILHO Asterio Pinto do MONTE-FILHO Moacir Martins FERNANDES Romulo Juventino COELHO Monique Couto MATOS Antonio Augusto Peixoto de SOUZA Orlando Jorge Martins TORRES |
| author_facet | Eduardo de Souza Martins FERNANDES Felipe Tavares de MELLO Joaquim RIBEIRO-FILHO Asterio Pinto do MONTE-FILHO Moacir Martins FERNANDES Romulo Juventino COELHO Monique Couto MATOS Antonio Augusto Peixoto de SOUZA Orlando Jorge Martins TORRES |
| author_sort | Eduardo de Souza Martins FERNANDES |
| collection | DOAJ |
| description | Background : Hepatopancreatoduodenectomy is one of the most complex abdominal operations mainly indicated in advanced biliary carcinoma. Aim : To present 10-year experience performing this operation in advanced malignant tumors. Methods : This is a retrospective descriptive study. From 2004 to 2014, 35 hepatopancreatoduodenectomies were performed in three different institutions. The most common indication was advanced biliary carcinoma in 24 patients (68.5%). Results: Eighteen patients had gallbladder cancer, eight Klatskin tumors, five neuroendocrine tumors with liver metastasis, one colorectal metastasis invading the pancreatic head, one intraductal papillary mucinous neoplasm with liver metastasis, one gastric cancer recurrence with liver involvement and one ocular melanoma with pancreatic head and right liver lobe metastasis. All patients were submitted to pancreatoduodenectomy with a liver resection as follows: eight right trisectionectomies, five right lobectomies, four left lobectomies, 18 central lobectomies (IVb, V and VIII). The overall mortality was 34.2% (12/35) and the overall morbidity rate was 97.4%. Conclusion : Very high mortality is seen when major liver resection is performed with pancreatoduodenectomy, including right lobectomy and trisectionectomy. Liver failure in combination with a pancreatic leak is invariably lethal. Efforts to ensure a remnant liver over 40-50% of the total liver volume are the key to obtain patient survival. |
| first_indexed | 2024-12-20T08:50:41Z |
| format | Article |
| id | doaj.art-27389fe2b4e64f21b02cf9673e03fd04 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-12-20T08:50:41Z |
| publishDate | 2016-03-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-27389fe2b4e64f21b02cf9673e03fd042022-12-21T19:46:07ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202016-03-01291172010.1590/0102-6720201600010005THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASESEduardo de Souza Martins FERNANDESFelipe Tavares de MELLOJoaquim RIBEIRO-FILHOAsterio Pinto do MONTE-FILHOMoacir Martins FERNANDESRomulo Juventino COELHOMonique Couto MATOSAntonio Augusto Peixoto de SOUZAOrlando Jorge Martins TORRESBackground : Hepatopancreatoduodenectomy is one of the most complex abdominal operations mainly indicated in advanced biliary carcinoma. Aim : To present 10-year experience performing this operation in advanced malignant tumors. Methods : This is a retrospective descriptive study. From 2004 to 2014, 35 hepatopancreatoduodenectomies were performed in three different institutions. The most common indication was advanced biliary carcinoma in 24 patients (68.5%). Results: Eighteen patients had gallbladder cancer, eight Klatskin tumors, five neuroendocrine tumors with liver metastasis, one colorectal metastasis invading the pancreatic head, one intraductal papillary mucinous neoplasm with liver metastasis, one gastric cancer recurrence with liver involvement and one ocular melanoma with pancreatic head and right liver lobe metastasis. All patients were submitted to pancreatoduodenectomy with a liver resection as follows: eight right trisectionectomies, five right lobectomies, four left lobectomies, 18 central lobectomies (IVb, V and VIII). The overall mortality was 34.2% (12/35) and the overall morbidity rate was 97.4%. Conclusion : Very high mortality is seen when major liver resection is performed with pancreatoduodenectomy, including right lobectomy and trisectionectomy. Liver failure in combination with a pancreatic leak is invariably lethal. Efforts to ensure a remnant liver over 40-50% of the total liver volume are the key to obtain patient survival.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000100017&tlng=ptPancreatic NeoplasmsHepatectomyPancreatectomy |
| spellingShingle | Eduardo de Souza Martins FERNANDES Felipe Tavares de MELLO Joaquim RIBEIRO-FILHO Asterio Pinto do MONTE-FILHO Moacir Martins FERNANDES Romulo Juventino COELHO Monique Couto MATOS Antonio Augusto Peixoto de SOUZA Orlando Jorge Martins TORRES THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES ABCD: Arquivos Brasileiros de Cirurgia Digestiva Pancreatic Neoplasms Hepatectomy Pancreatectomy |
| title | THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES |
| title_full | THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES |
| title_fullStr | THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES |
| title_full_unstemmed | THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES |
| title_short | THE LARGEST WESTERN EXPERIENCE WITH HEPATOPANCREATODUODENECTOMY: LESSONS LEARNED WITH 35 CASES |
| title_sort | largest western experience with hepatopancreatoduodenectomy lessons learned with 35 cases |
| topic | Pancreatic Neoplasms Hepatectomy Pancreatectomy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000100017&tlng=pt |
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