Hepatopancreatoduodenectomy for perihilar cholangiocarcinoma following laparoscopic total gastrectomy

Naokazu Chiba, Takahiro Gunji, Yosuke Ozawa, Kosuke Hikita, Toru Sano, Koichi Tomita, Yuta Abe, Shigeyuki Kawachi

Research output: Contribution to journalArticle

Abstract

Introduction Surgical resection is the only curative treatment for perihilar cholangiocarcinoma. However, Hepatopancreatoduodenectomy (HPD) procedure remains controversial in regard to the balance between the survival benefit and high risk of mortality and morbidity. Presentation of case A 72-year-old man who was revealed the dilation of intrahepatic hepatic duct by computed tomography after laparoscopic total gastrectomy was referred to our hospital. The patient had undergone laparoscopic total gastrectomy with Roux-en-Y esophageal-jejunostomy reconstruction 1 year previously. By several examinations, we consequently diagnosed this case as a perihilar cholangiocarcinoma and performed HPD. Histological examination revealed a well differentiated adenocarcinoma without lymph-node metastasis and a negative margin of liver parenchyma and pancreas. He was recovered from a grade B pancreatic fistula by conservative therapy and discharged post-operatively on day 64 in good health. The patient received postoperative systemic chemotherapy with gemcitabine for 6 months. 16 months after surgery, the patient has had no recurrence. Discussion HPD for biliary and cancers after total gastrectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide the chance for long-term survival if curative resection is feasible. Conclusion This case was the first report of hepatopancreatoduodenectomy following laparoscopic total gastrectomy.

Original languageEnglish
Pages (from-to)209-211
Number of pages3
JournalInternational Journal of Surgery Case Reports
Volume41
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Hepatopancreatoduodenectomy
  • Laparoscopic total gastrectomy
  • Perihilar cholangiocarcinoma

ASJC Scopus subject areas

  • Surgery

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