1 Jul 2019Article
Synchronous pancreas and liver resection during CRS ± HIPEC. Results of 35 consecutive patients
Özgül Düzgün 1Fatma Kulalı 2Ceren Göret 3Gülçiçek Ayrancı 3Fikret Ezberci 1Ömer Özkan 1
Affiliations
Article Info
1 Department of General Surgery, Health Sciences University, Umraniye Research and Education Hospital, Istanbul, Turkey
2 Department of Radiology, Health Sciences University, Umraniye Research and Education Hospital, Istanbul, Turkey
3 Department of Surgical Pathology, Health Sciences University, Sancaktepe Research and Education Hospital, Istanbul, Turkey ****Department of Surgical Pathology, Health Sciences University, Umraniye Research and Education Hospital, Istanbul, Turkey
Ann. Ital. Chir., 2019, 90(4), 297-304;
Published: 1 Jul 2019
Copyright © 2019 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: 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). MATERIAL AND METHODS: 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. RESULTS: 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%. CONCLUSION: 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.
Keywords
- Cytoreductive surgery
- Hepatopancreatobiliary surgery
- HIPEC
- Peritoneal carcinomatosis