National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

Tomoko Yoshimoto-Haramura, Masaaki Hidaka, Kiyoshi Hasegawa, Kazuhiro Suzumura, Nobuyuki Takemura, Naoki Hama, Takashi Mizuno, Takeo Nomi, Tsuyoshi Kobayashi, Keiji Sano, Hiroshi Yokomizo, Hiroyuki Nitta, Masanao Kurata, Yasushi Hasegawa, Minoru Nagayama, Masaji Tani, Takumi Fukumoto, Masayuki Ohta, Hironori Hayashi, Hiroki TaniguchiShinichiro Ishino, Tsukasa Aihara, Takaaki Murase, Akihiko Tsuchida, Tsuyoshi Shimamura, Shigeru Marubashi, Junichi Kaneko, Takanobu Hara, Hajime Matsushima, Akihiko Soyama, Tomoyuki Endo, Susumu Eguchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Approximately 8300 hemophiliacs are registered in Japan, but no comprehensive reports on hepatobiliary and pancreatic surgery (HBPS) have been conducted. This report investigates the current status of HPBS in hemophilia patients in Japan. Methods: The subjects were hemophiliac patients seen between January 1 2007, and December 31 2017, at facilities participating in this study among the facilities for performing high-difficulty cases nationwide designated by the Japanese Society for HBPS. A retrospective examination of short-term outcomes in 49 cases was conducted to assess patient background, disease, surgical procedure, and complications. Results: The types of hemophilia were A: 43 cases, B: four cases, and von Willebrand disease: two cases (hemophilia severity: mild 32, moderate seven, severe 10). The target malignant diseases for surgery were hepatocellular carcinoma (HCC) in 20 cases, intrahepatic cholangiocellular carcinoma (CCC) in four cases, combined HCC-CCC in two cases, hilar CCC in two cases, and pancreatic cancer in four cases. As for the surgical procedure, limited resection (subsegmentectomy and partial hepatectomy) was performed in 16 cases of HCC even with normal liver function tests. Pancreaticoduodenectomy and distal pacreatectomy were performed for pancreatic cancers as in the standard procedure. Postoperative complications were postoperative bleeding in two cases after hepatectomy and one after pancreatectomy in one case. When compared with Japanese National Clinical Data base, the complication rates after hepatectomy and pancreatectomy were not conspicuous in hemophilic patients. Conclusions: As long as they are performed in qualified centers, complication rate is not increased in hemophilic patients undergoing HBPS.

Original languageEnglish
JournalJournal of Hepato-Biliary-Pancreatic Sciences
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • cancer
  • hemophilia
  • hepatobiliary
  • pancreas
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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