J.Jpn. Surg. Soc.. 88(9): 1332-1335, 1987

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Report on the annual meeting

HEPATOPANCREATODUODENECTOMY FOR CARCINOMA OF THE GALLBLADDER INVASIVE TO BOTH THE LIVER AND THE HEPATODUODENAL LIGAMENT

Various imaging methods have made it easier to find polypoid lesions of the gallbladder. However, the detection and the treatment of gallbladder carcinoma are still unsatisfactory. The results of surgical treatment are often miserable due to invasions to both the liver and hepatoduodenal ligament. For improved surgical results, the hepatic lobe and pancreatic head should be removed at once, that is, hepatopancreatoduodenectomy (HPD) should be performed. During eight years, we have applied HPD to 16 out of 40 invasive cases (40％). The portal vein or the hepatic artery was resected in combination or each respectively in eight cases (50％). Operative mortality, defined as death within 30 days after surgery, was 6/16 (37.5％). Three cases have survived more than two years postoperatively (18.8％). Pathological study revealed hepatic infiltration in all cases, invasion to the bile duct in ten, to the duodenum in ten, to the pancreatic head in three, peritoneal dissemination in two and limited hepatic metastases in two Lymph-node metastases were often seen in the regions of the common hepatic artery (37.5％), hepatoduodenal ligalnent (56.3％) and pancreatic head (50％). Based on pathological analysis, 43.8％ of HPD operations were considered curative.

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