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A resected case of hepato-pancreaticoduodenectomy for widely extended cholangiocarcinoma undergoing previous intra-abdominal poly-surgery. | LitMetric

AI Article Synopsis

  • A 61-year-old woman with obstructive jaundice was diagnosed with extensive cholangiocarcinoma after previously undergoing multiple surgeries for gall bladder cancer.
  • Successful radical surgery, including left hepatectomy and pancreaticoduodenectomy, was performed without complications due to careful preoperative diagnosis.
  • The case highlights the need for skilled surgical approaches and an aggressive treatment strategy in patients with a history of major abdominal surgeries and complex cancers.

Article Abstract

Introduction: This case report describes a successful radical operation for a patient with extensive advanced cholangiocarcinoma who had previously undergone intra-abdominal poly-surgery for advanced gall bladder carcinoma. Careful diagnosis to define the adequate division of the right hepatic duct was performed, and the operation was completed without postoperative complications.

Case Presentation: A 61-year-old woman was admitted to a hospital for obstructive jaundice, and extra-hepatic cholangiocarcinoma was found. Seven years prior, she underwent poly-surgery, which included cholecystectomy, gastrectomy, and colectomy, for advanced gall bladder carcinoma. Although she did not receive adjuvant chemotherapy, she had no tumor relapse. She was recommended chemo-radiation therapy to treat the cholangiocarcinoma; however, she visited our hospital to inquire the possibility of receiving radical operation. Enhanced computed tomography showed extensive cholangiocarcinoma without distant metastases, which was confirmed by endoscopic biopsy. Since the transected bile duct was without cancer-invasion, which was confirmed by a negative biopsy result, we were able to perform radical left hepatectomy and pancreaticoduodenectomy (HPD). The patient was discharged without any complications. Careful preoperative examination allowed for a complex operation to be successfully completed.

Discussion: Complex surgery for advanced hepato-biliary-pancreatic malignancies after poly-surgery is difficult and requires expertise and intensive postoperative care.

Conclusion: HPB surgeons should adopt an aggressive policy to treat patients who have undergone previous major abdominal surgery.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215962PMC
http://dx.doi.org/10.1016/j.ijscr.2018.10.035DOI Listing

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