Authors: Anil K Agarwal Sanjoy Mandal Shivendra Singh Puja Sakhuja Sunil Puri
Publish Date: 2007/09/29
Volume: 11, Issue: 12, Pages: 1722-1727
Abstract
A total of 252 patients of gallbladder cancer GBC who underwent surgery over a 5year period were studied for duodenal involvement Patients with duodenal infiltration on peroperative assessment were analyzed for resectability postoperative morbidity mortality and disease free survivalFortythree patients were detected to have duodenal infiltration on peroperative assessment out of which 17 had unresectable disease 3954 whereas the remaining 26 patients underwent R0 resection 619 Of these nine underwent distal gastrectomy with resection of the first part of the duodenum 3462 16 underwent duodenal sleeve resection 6154 and in one patient pancreatoduodenectomy HPD 385 was performed With regard to the extent of liver resection two underwent extended right hepatectomy whereas the remaining 24 underwent segment IVB and V resection Bile duct and adjacent viscera were resected when involved Of the resected patients eight underwent bile duct excision seven had colonic resection and three had vascular resection and reconstruction The postoperative morbidity and mortality was 15 349 and three 697 respectively in the resected group of patients The overall actual survival in the resected group was a mean of 1587 months median of 14 months range 3 to 56 monthsDuodenal infiltration is neither an indicator of unresectability nor an indication to perform Hepatopancreatoduodenectomy HPD In most of these patients an oncologically adequate R0 resection can be performed with either a duodenal sleeve resection or distal gastrectomy with resection of the first part of the duodenum
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