A modified surgical approach of hepatopancreatoduodenectomy for advanced gallbladder cancer: Report of two cases and literature review.

Q Engineering
Jian Wang, Zhan-Guo Zhang, Wan-Guang Zhang
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引用次数: 2

Abstract

Gallbladder cancer (GBC) is the most common cancer of the biliary tract, constituting 80%-95% of malignant biliary tract tumors. Surgical resection is currently regarded as the sole curative treatment for GBC. Hepatopancreatoduodenectomy (HPD) has been adopted to remove the advanced gallbladder tumor together with the infiltrated parts within the liver, lower biliary tract and the peripancreatic region of GBC patients. However, patients who underwent HPD were reported to have a distinctly higher postoperative morbidity (71.4%, ranging from 30.8% to 100%) and mortality (13.2%, ranging from 2.4% to 46.9%) than those given pancreatoduodenectomy (PD) alone. We present two patients with advanced GBC who underwent a modified surgical approach of HPD: PD with microwave ablation (MWA) of adjacent liver tissues and the technique of intraductal cooling of major bile ducts. No serious complications like bile leakage, pancreatic fistula, hemorrhage and organ dysfunction, etc. occurred in the two patients. They had a rapid recovery with postoperative hospital stay being 14 days. Application of this approach effectively eliminated tumor-infiltrated adjacent tissues, and maximally reduced the postoperative morbidity and mortality. This modified surgical method is secure and efficacious for the treatment of locally advanced GBC.

改良的肝胰十二指肠切除术治疗晚期胆囊癌2例报告并文献复习。
胆囊癌(GBC)是最常见的胆道肿瘤,占胆道恶性肿瘤的80%-95%。手术切除目前被认为是治疗GBC的唯一方法。GBC患者采用肝胰十二指肠切除术(HPD)切除晚期胆囊肿瘤及肝脏内浸润部位、胆道下段及胰周区。然而,与单独行胰十二指肠切除术(PD)的患者相比,行胰十二指肠切除术的患者术后发病率(71.4%,范围从30.8%到100%)和死亡率(13.2%,范围从2.4%到46.9%)明显更高。我们报告了两例晚期GBC患者,他们接受了一种改良的HPD手术方法:微波消融(MWA)邻近肝组织的PD和导管内冷却主要胆管技术。两例患者均未发生胆漏、胰瘘、出血、脏器功能障碍等严重并发症。术后住院14天,恢复迅速。应用该入路可有效消除肿瘤浸润的邻近组织,最大限度地降低术后发病率和死亡率。这种改良的手术方法对于局部晚期GBC的治疗是安全有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.08
自引率
0.00%
发文量
0
审稿时长
3-8 weeks
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