Radical resection combined with liver transplantation for foregut tumors

• Published in: The American surgeon Vol. 59; no. 12; p. 806
• Main Authors: Farmer, D G, Shaked, A, Colonna, 2nd, J O, Olthoff, K M, Jurim, O, Colquhoun, S, Millis, J M, Busuttil, R W
• Format: Journal Article
• Language: English
• Published: United States 01-12-1993
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Bile Duct Neoplasms - mortality; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Carcinoma, Neuroendocrine - mortality; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - surgery; Cholangiocarcinoma - mortality; Cholangiocarcinoma - pathology; Cholangiocarcinoma - surgery; Combined Modality Therapy; Female; Graft Survival; Hepatoblastoma - mortality; Hepatoblastoma - pathology; Hepatoblastoma - surgery; Humans; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver Transplantation; Male; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Postoperative Complications - epidemiology; Retrospective Studies; Survival Rate; Time Factors
• ISSN: 0003-1348

Between February 1984 and July 1992, six adults with advanced pancreatic adenocarcinoma (n = 1), pancreatic neuroendocrine tumor (n = 2), and cholangiocarcinoma (n = 3) underwent radical foregut resections (n = 3) or radical pancreaticoduodenectomy (n = 3) combined with liver transplantation. The major postoperative complications included diarrhea (n = 4), pancreaticojejunostomy leak (n = 3), infection (n = 7), malnutrition (n = 3), refractory ascites (n = 2), and late hepatic artery thrombosis (n = 1). Tumor recurrence occurred in one patient. The actuarial survival for the group is 82 per cent at 1 year and 55 per cent at 2 years. The results demonstrate that radical pancreaticoduodenectomy/foregut resections combined with liver transplantation offer potential surgical cure of malignancies involving these organs. However, the procedure is formidable, with frequent complications.