Pancreaticoduodenectomy with radical lymphadenectomy is not contraindicated for patients with established chronic liver disease and portal hypertension

作     者：Harsheet Sethi Parthi Srinivasan Gabriele Marangoni Andreas Prachalias Mohamed Rela Nigel Heaton 

作者机构：Institute of Liver StudiesKings College London School of Medicine at Kings College HospitalDenmark HillLondon SE5 9RSUK 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2008年第7卷第1期

页      面：82-85页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：pancreaticoduodenectomy Whipple's cirrhosis chronic liver disease portal hypertension 

摘      要：BACKGROUND: hronic liver disease has been considered a contraindication to radical surgery for intra-abdominal tumors because of the risk of decompensation. METHODS: In a retrospective analysis of all patients undergoing pancreaticoduodenectomy for cancer treated from January 2000 to December 2006 at our center, 4 patients were identified with operable pancreatic tumors and well-compensated chronic liver disease. The preoperative staging, decompression of the biliary tree, liver biopsy, Child-Turcot-Pugh and MELD scores were ***: All patients underwent pancreaticoduodenectomy successfully with minimal blood loss, and no peri-operative blood transfusions or liver decompensation. There was no postoperative mortality. Two patients received adjuvant chemotherapy. One patient died with recurrent disease at 18 months, one is alive with disease recurrence, and two are alive and disease ***: Patients with pancreatic cancer and well-compensated chronic liver disease should routinely be considered for radical surgery at specialist hepatobiliary centres with expertise available to manage complex liver disease.