F. Yoshimi et al., Comparison between pancreatoduodenectomy and hepatopancreatoduodenectomy for bile duct cancer, HEP-GASTRO, 48(40), 2001, pp. 994-998
Background/Aims: Pancreatoduodenectomy has been accepted as a standard oper
ative procedure for distal bile duct cancer with low operative mortality. H
owever, hepatopancreatoduodenectomy has not been accepted as a standard tre
atment modality for diffuse bile duct cancer.
Methodology: From December 12, 1992 to December 15, 2000, 37 patients with
the diagnosis of extrahepatic bile duct adenocarcinoma (cholangiocarcinoma)
underwent pancreatoduodenectomy or hepatopancreatoduodenectomy, at the dep
artment of surgery, Ibaraki Prefectural Central Hospital and the Cancer Cen
ter. The differences in indications and results of both operative procedure
s were investigated retrospectively.
Results: Thirty-day operative mortality was 0% after either pancreatoduoden
ectomy or hepatopancreatoduodenectomy. One- to 5-year cumulative survival r
ates for the 24 patients after pancreatoduodenectomy were 76.3%, 41.5%, 41.
5%, 41.5%, 41.5%, respectively. One- to 4-year cumulative survival rates fo
r the 13 patients after hepatopancreatoduodenectomy were 48.0% 32.0% 32.0%
16.0%, respectively. There were no statistically significant differences be
tween cumulative survival rates after pancreatoduodenectomy and hepatopancr
eatoduodenectomy either in all the patients or in patients with UICC stage
IV.
Conclusions: Hepatopancreatoduodenectomy should be tried for patients with
diffuse bile duct cancer, because only hepatopancreatoduodenectomy has the
possibility of a cure at this time.