Bile duct segmental resection versus pancreatoduodenectomy for middle and distal common bile duct cancer.
10.4174/astr.2018.94.5.240
- Author:
Naru KIM
1
;
Huisong LEE
;
Seog Ki MIN
;
Hyeon Kook LEE
Author Information
1. Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea. huisong.lee@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Cholangiocarcinoma;
Common bile duct neoplasms;
Pancreaticoduodenectomy;
Recurrence;
Survival
- MeSH:
Bile Duct Neoplasms;
Bile Ducts*;
Bile*;
Cholangiocarcinoma;
Common Bile Duct Neoplasms;
Common Bile Duct*;
Follow-Up Studies;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Pancreaticoduodenectomy*;
Recurrence;
Retrospective Studies;
Surgeons
- From:Annals of Surgical Treatment and Research
2018;94(5):240-246
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare survival outcomes between bile duct segmental resection (BDR) and pancreatoduodenectomy (PD) for the treatment of middle and distal bile duct cancer. METHODS: From 1997 to 2013, a total of 96 patients who underwent curative intent surgery for middle and distal bile duct cancer were identified. The patients were divided into 2 groups based on the type of operation; 20 patients were included in the BDR group and 76 patients were in the PD group. We retrospectively reviewed the clinical outcomes. RESULTS: The number of lymph nodes (LNs) was significantly greater in patients within the PD group compared to the BDR group. The total number of LNs was 6.5 ± 8.2 vs. 11.2 ± 8.2 (P = 0.017) and the number of metastatic LNs was 0.4 ± 0.9 vs. 1.0 ± 1.5 (P = 0.021), respectively. After a median follow-up period of 24 months (range, 4–169 months), the recurrence-free survival of the PD group was superior to that of the BDR group (P = 0.035). In the patients with LN metastases, the patients undergoing PD had significantly better survival than the BDR group (P < 0.001). CONCLUSION: Surgeons should be cautious in deciding to perform BDR for middle and distal common bile duct cancer. PD is recommended if LN metastases are suspected.
