Comparison of Survival Outcomes following Segmental Bile Duct Resection versus Pancreatoduodenectomy for Mid Bile Duct Cancer.
- Author:
Seok In SEO
1
;
Shin HWANG
;
Young Joo LEE
;
Ki Hun KIM
;
Chul Soo AHN
;
Deok Bog MOON
;
Tae Yong HA
;
Gi Won SONG
;
Dong Hwan JUNG
;
Kwang Min PARK
;
Dae Wook HWANG
;
Sung Gyu LEE
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. shwang@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Bile duct cancer;
Recurrence;
Pancreatoduodenectomy;
Segmental bile duct resection
- MeSH:
Bile;
Bile Duct Neoplasms;
Bile Ducts;
Follow-Up Studies;
Humans;
Medical Records;
Pancreaticoduodenectomy;
Prognosis;
Recurrence;
Retrospective Studies;
Risk Factors;
Survival Rate
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011;15(1):42-49
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was designed to analyze the prognosis following segmental bile duct resection (BDR) versus pancreatoduodenectomy (PD) for mid bile duct (mBD) cancer. METHODS: During the 4 years between 2003 and 2006, 55 patients underwent surgical resection for mBD cancer in our institution. Medical records were reviewed retrospectively. They were divided into two groups, a BDR group (n=24) and a PD group (n=31) according to the extent of resection. RESULTS: Median follow-up was 43 months. Overall 3- and 5-year survival rates were 56.0% and 33.8%, respectively. The BDR group had lower tumor stages than the PD group (p=0.011). R0 resection was achieved in 17 (70.8%) of the BDR group and 30 (96.8%) of the PD group. Median survival periods were 43 and 34 months after R0 and R1 resections, respectively (p=0.715). Recurrence occurred in 41 patients after a mean period of 18 months. Three- and 5-year survival rates were 62.5% and 27.2% after BDR, respectively, and 51.5% and 34% after PD, respectively (p=0.715). No significant risk factors for shorter patient survival times was identified. Aggressive treatment of recurrence did not appear to prolong patient survival. CONCLUSION: The extent of resection for mBD cancer did not affect the survival outcome when R0 resection was achieved. Considering the operative risk in patients with older ages or co-morbidities, PD should be considered only after obtainment of simultaneous tumor-free radial and proximal longitudinal resection margins.
