Abstract
IntroductionCirrhosis is a risk factor for poor outcomes in non-hepatic oncological resections. There are only a handful of cases demonstrating outcomes of pancreaticoduodenectomy (PD) in patients with pancreatic cancer and underlying cirrhosis. Moreover, pushing the limits of PD to elderly cirrhotic patients and demonstrating its safety remains under reported. Case presentationHere, we report successful management of a 71 year-old-lady with HCV related liver cirrhosis, obstructive jaundice and poor performance status, who was medically optimized and then underwent PD for adenocarcinoma of the head of pancreas. There was no major post-operative morbidity except minor chyle leak which resolved spontaneously. On her last follow up, she was doing well and undergoing adjuvant chemotherapy. DiscussionPreoperative medical optimization and careful patient selection can yield successful outcomes even after a major abdominal surgery like PD in elderly patients with underlying liver cirrhosis. ConclusionLiver cirrhosis is not a contra indication to PD in elderly patients with good performance status.
Highlights
Cirrhosis is a risk factor for poor outcomes in non-hepatic oncological resections
Presence of liver cirrhosis increases the risk of adverse post operative outcomes [1,2]
A 71 year-old-lady with past history of hepatitis C virus (HCV) related cirrhosis was referred to the surgical clinic for obstructive jaundice
Summary
There are only a handful of cases demonstrating outcomes of pancreaticoduodenectomy (PD) in patients with pancreatic cancer and underlying cirrhosis. CASE PRESENTATION: Here, we report successful management of a 71 year-old-lady with HCV related liver cirrhosis, obstructive jaundice and poor performance status, who was medically optimized and underwent PD for adenocarcinoma of the head of pancreas. There was no major post-operative morbidity except minor chyle leak which resolved spontaneously. On her last follow up, she was doing well and undergoing adjuvant chemotherapy. DISCUSSION: Preoperative medical optimization and careful patient selection can yield successful outcomes even after a major abdominal surgery like PD in elderly patients with underlying liver cirrhosis. CONCLUSION: Liver cirrhosis is not a contra indication to PD in elderly patients with good performance status
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