RADICAL RESECTION COMBINED WITH LIVER-TRANSPLANTATION FOR FOREGUT TUMORS

Between February 1984 and July 1992, six adults with advanced pancreat ic adenocarcinoma (n=1), pancreatic neuroeudocrine tumor (n=2), and ch olangiocarcinoma (n=3) underwent radical foregut resections (n=3) or r adical pancreaticoduodenectomy (n=3) combined with liver transplantati on. The major postoperative complications included diarrhea (n=4), pan creaticojejunostomy leak (n=3), infection (n=7), malnutrition (n=3), r efractory ascites (n=2), and late hepatic artery thrombosis (n=1). Tum or recurrence occurred in one patient. The actuarial survival for the group is 82 per cent at 1 year and 55 per cent at 2 years. The results demonstrate that radical pancreaticoduodenectomy/foregut resections c ombined with liver transplantation offer potential surgical cure of ma lignancies involving these organs. However, the procedure is formidabl e, with frequent complications.