A systematic review of the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.

Abstract

To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers. Medline and EMBASE were systematically searched for papers describing hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers. Eighteen studies involving 397 patients were reviewed. A major hepatectomy was undertaken in 81.3% of the 397 patients, and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median=31%). The 5-year survival rate in patients who underwent a curative resection was 18-68.8% (median=51.3%), and 0% in patients who received a non-curative resection. A hepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom a curative resection is feasible.