Back to Search
Start Over
Hepatopancreatoduodenectomy -a controversial treatment for bile duct and gallbladder cancer from a European perspective
- Source :
- HPB, 22(9), 1339-1348. ELSEVIER SCI LTD, HPB: The official journal of the International Hepato Pancreato Biliary Association, 22(9), 1339-1348. John Wiley and Sons Inc., Hpb, 22(9), 1339-1348. ELSEVIER SCI LTD
- Publication Year :
- 2020
- Publisher :
- ELSEVIER SCI LTD, 2020.
-
Abstract
- BACKGROUND: Hepatopancreatoduodenectomy (HPD) is an aggressive operation for treatment of advanced bile duct and gallbladder cancer associated with high perioperative morbidity and mortality, and uncertain oncological benefit in terms of survival. Few reports on HPD from Western centers exist. The purpose of this study was to evaluate safety and efficacy for HPD in European centers.METHOD: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients operated with HPD for bile duct or gallbladder cancer between January 2003 and January 2018. The patient and tumor characteristics, perioperative and survival outcomes were analyzed.RESULTS: In total, 66 patients from 19 European centers were included in the analysis. 90-day mortality rate was 17% and 13% for bile duct and gallbladder cancer respectively. All factors predictive of perioperative mortality were patient and disease-specific. The three-year overall survival excluding 90-day mortality was 80% for bile duct and 30% for gallbladder cancer (P = 0.013). In multivariable analysis R0-resection had a significant impact on overall survival.CONCLUSION: HPD, although being associated with substantial perioperative mortality, can offer a survival benefit in patient subgroups with bile duct cancer and gallbladder cancer. To achieve negative resection margins is paramount for an improved survival outcome.
- Subjects :
- medicine.medical_specialty
RESECTION
LIVER
PERIHILAR CHOLANGIOCARCINOMA
INTERNATIONAL STUDY-GROUP
Improved survival
030230 surgery
BILIARY
Gastroenterology
Bile duct cancer
03 medical and health sciences
0302 clinical medicine
MAJOR HEPATECTOMY
Internal medicine
medicine
Hepatectomy
Humans
In patient
Gallbladder cancer
Hepatology
Bile duct
business.industry
PANCREATIC FISTULA
Mortality rate
Perioperative
medicine.disease
RISK SCORE
Bile Ducts, Intrahepatic
medicine.anatomical_structure
DEFINITION
Bile Duct Neoplasms
030220 oncology & carcinogenesis
PANCREATICODUODENECTOMY
Gallbladder Neoplasms
Bile Ducts
business
Subjects
Details
- Language :
- English
- ISSN :
- 1365182X
- Volume :
- 22
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Hpb
- Accession number :
- edsair.doi.dedup.....e78ed113bd4fc59bb3f6b0b5acf5f39f