Technical knacks and outcomes of extended extrahepatic bile duct resection in patients with mid bile duct cancer
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 109-112, 2013.
Article
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| ID: wpr-63500
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WPRO
ABSTRACT
BACKGROUNDS/AIMS: Mid bile duct cancers often involve the proximal intrapancreatic bile duct, and resection of the extrahepatic bile duct (EHBD) can result in a tumor-positive distal resection margin (RM). We attempted a customized surgical procedure to obtain a tumor-free distal RM during EHBD resection, so that R0 resection can be achieved without performing pancreaticoduodenectomy through extended EHBD resection. METHODS: We previously reported the surgical procedures of extended EHBD resection, in which the intrapancreatic duct excavation resembles a > or =2 cm-long funnel. This unique procedure was performed in 11 cases of mid bile duct cancer occurring in elderly patients between the ages of 70 and 83 years. RESULTS: The tumor involved the intrapancreatic duct in all cases. Deep pancreatic excavation per se required about 30-60 minutes. Cancer-free hepatic duct RM was obtained in 10 patients. Prolonged leakage of pancreatic juice occurred in 2 patients, but all were controlled with supportive care. Adjuvant therapies were primarily applied to RM-positive or lymph node-positive patients. Their 1-year and 3-year survival rates were 90.9% and 60.6%, respectively. CONCLUSIONS: We suggest that extended EHBD resection can be performed as a beneficial option to achieve R0 resection in cases in which pancreaticoduodenectomy should be avoided due to various causes including old age and expectation of a poor outcome.
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Texto completo:
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Índice:
WPRIM
Asunto principal:
Jugo Pancreático
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Bilis
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Neoplasias de los Conductos Biliares
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Conductos Biliares
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Tasa de Supervivencia
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Pancreaticoduodenectomía
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Conductos Biliares Extrahepáticos
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Conducto Hepático Común
Límite:
Aged
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Humans
Idioma:
En
Revista:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Año:
2013
Tipo del documento:
Article