Synchronous pancreas and liver resection during CRS ± HIPEC. Results of 35 consecutive patients

• Published in: Annali italiani di chirurgia Vol. 90; p. 297
• Main Authors: Düzgün, Özgül, Kulalı, Fatma, Göret, Ceren Canbey, Ayrancı, Gülçiçek, Ezberci, Fikret, Özkan, Ömer Faruk
• Format: Journal Article
• Language: English
• Published: Italy 2019
• Subjects: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Cytoreduction Surgical Procedures - methods; Female; Hepatectomy - methods; Humans; Hyperthermia, Induced; Liver Neoplasms - therapy; Middle Aged; Neoplasms, Multiple Primary - therapy; Pancreatectomy - methods; Pancreatic Neoplasms - therapy; Peritoneal Neoplasms - therapy; Retrospective Studies; Time Factors; Treatment Outcome
• EISSN: 2239-253X

To evaluate the results of synchronous pancreas and liver resection in patients with metastatic carcinoma accompanied by peritoneal carcinomatosis (PC) who underwent cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC).
Overall, 35 patients with PC who underwent CRS/HIPEC at Umraniye Education and Research Hospital owing to different etiological causes were evaluated for operation procedure, age, sex, comorbid diseases, ASA score, systemic chemo/radiotherapy, duration of surgery, chemotherapy (CT) protocol applied in HIPEC, amount of bleeding, synchronous hepatobiliary resection interventions during operation and short/long-term mortality and morbidity.
Fifteen patients were male and 20 were female. Mean age was 58.375 ± 13.02 (range, 27-85) years. CRS/HIPEC was performed in 12 patients (34.3%), whereas only CRS was performed in 23 (65.7%) patients. The lowest and highest perioperative bleeding amount was 50 cc and 2000 cc, respectively, and 6 (17.1%) patients had intraoperative bleeding of ≥1000 cc. Synchronous isolated pancreatic resection, hepatic + pancreatic resection and isolated liver resection was performed in 3 (8.6%), 5 (14.3%) and 27 (77.1%) patients treated with CRS/HIPEC. Two patients died within postoperative day 30, and the mortality rate was 5.7%.
Hepatopancreatobiliary surgery is a difficult intervention and is associated with serious morbidities. Synchronisation of hepatopancreatobiliary surgery with CRS/HIPEC may be challenging for the surgeon and clinician. Here we emphasise that this combination can be performed safely by an experienced team with a multidisciplinary approach and good patient preparation.
Cytoreductive surgery, HIPEC, Hepatopancreatobiliary surgery, Peritoneal carcinomatosis.