CLINICAL EVALUATION OF HEPATOPANCREATODUODENECTOMY

Abstract

In spite of a progress of the imaging diagnosis, many advanced cancers are found in the pancreatobiliary lesion. The operative indication for hepatopancreatoduodenectomy (HPD) has been increasing. From July 1987 to Aug 1991, HPD was performed in 10 cases. Major hepatic resection in which more than two segments were resected was performed in 7 cases. Minor hepatic resection in which less than two segments were resected was performed in 3 cases. Operative mortality rate was 30% and median survival time was 1.34 years in all HPD cases. While these figures were 28% and was 1.2 years respectively in HPD cases with major hepatic resection. In HPD with major hepatic resection, preoperative high serum bilirubin and cholangitis were considered to be the operative risk factors. The peak value of postoperative serum alkaline phosphatase well corresponded to the results of the operation in survivors. The two non-survivors undergoing HPD with major hepatic resection were all men and their diagnoses were superficial spread type bile duct cancer. Two cases of long survivors were recorded. We would intend to improve the results of HPD by renovation of preoperative and operative management.