Operative Results and Quality of Life After Hepatopancreatoduodenectomy for Cancer of the Biliary Tract

Tatsuya Yoshikawa, Fujio Hanyu, Mitsuji Nakamura, Toshihide Imaizumi, Osamu Miura, Toshiaki Nagasako, Toru Fujita, Tsukasa Azuma, Yoshiko Ogawa

Department of Surgery, the Institute of Gastroenterology, Tokyo Women's Medical College

We reviewed our experience with 50 patients who had hepatopancreatoduodenectomv (HPD) for carcinoma of the bile duct and the gallbladder. Thirteen patients died within one month after HPD for an operative mortality rate of 26%. The operative mortality rate was strongly related to the extent of hepatic resection. In the patients who had pancreatoduodenectomy and extended right hepatectomy, the operative mortality rate was 63%, whereas it was 3.2% in those with pancreatduodenectomy and partial or segmental hepatic resection. Nineteen (38%) of the 50 patients had curative operations. Thirty six patients were selected for survival study. Three-year survival rate was 19%. The three-year survival rate for the patients with curative operation was 46%. Among the 16 patients who have survived more than one year after the operation, 13 (81%) have achieved a good quality of daily living (PS 0 in 1 and PS 1 in 12), which was not related to the extent of hepatic resection. HPD can produce good survival and a favorable postoperative performance status for patients with carcinoma of the bile duct and the gallbladder.

Key words
cancer of the biliary tract, hepatopancreatoduodenectomy, pancreatoduodenectomy, quality of life

Reprint requests
Tatsuya Yoshikawa The Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
December 13, 1989

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