STUDY OF COMPLICATIONS AFTER RESECTION OF BILIARY TRACT CANCER

Abstract

Seventy-two patients who underwent resection of biliary tract cancer in the department were examined for early and late postoperative complications. They included 32 patients with gallbladder cancer, 28 with bile duct cancer and 12 with papillary cancer, treated by pancreatoduodenectomy (26 cases), combined hepatectomy and pancreatectomy (13 cases), two or more hepatic segmentectomy (10 cases) and other methods (23 cases). Early postoperative complications, occurring within two months after surgery, were found in 23 (31.9%) patients, and 9 (12.5%) died consequently. Hyperbilirubinemia (10 cases), sutural insufficiency (8 cases) and after-bleeding (6 cases) were conspicuous, showing high incidences of 60.0% and 53.8% after two or more hepatic segmentectomy and after combined hepatectomy and pancreatectomy, respectively. Late complications occurred in 7 (46.7%) of 15 patients who had no recurrence for 2 or more years after surgery, and 4 (26.7%) died. The four patients died had undergone pancreatoduodenectomy, their complications being nutritional disturbance in two and chronic hepatic disorder in other two. Severe complications were found only after pancreatoduodenectomy, other surgical techniques being associated with mild complications. Considering the fact that 5 deaths from cancer occurred two or more years after surgery, total body management of patients long after pancreatoduodenectomy is important. In selecting the method of surgery for biliary tract cancer, due attention should be paid not only to the radicality of the operation but also to possible postoperative complications.