caa a22 4500 477034675 CHVBK 20180405111302.0 cr unu---uuuuu 170330e19960101xx s 000 0 eng 10.1007/s002689900014 doi (NATIONALLICENCE)springer-10.1007/s002689900014 Outcome of Major Hepatectomy with Pancreatoduodenectomy for Advanced Biliary Malignancies [Elektronische Daten] [Shinichi Miyagawa, Masatoshi Makuuchi, Seiji Kawasaki, Ken Hayashi, Haruhisa Harada, Hiroshi Kitamura, Hitoshi Seki] Abstract. In patients with advanced biliary malignancies a chance of curability is obtained by performing only major hepatectomy with concomitant pancreatoduodenectomy. This aggressive procedure carries two major risks: hepatic failure and pancreatic anastomotic leakage. Ten patients with advanced biliary malignancies were treated by major hepatectomy with pancreatoduodenectomy. Nine patients underwent right portal venous embolization before hepatectomy. Complete external drainage of pancreatic juice followed by second-stage pancreatojejunostomy was performed in five patients. Three of these five underwent concomitant resection of the hepatic artery, portal vein, or both. Pancreatogastrostomy was chosen for five patients who required no concomitant vascular resection. There were no hospital deaths or hepatic failures. Leaks from pancreatogastrostomy occurred in two patients. In five patients who underwent external drainage of pancreatic juice, there were no complications related to the pancreatic stump, although one had ischemic necrosis of the jejunal segment and laparotomy was repeated. Mean survival time was 31.8 months (range 13-59 months). Portal venous embolization and complete external drainage of pancreatic juice followed by late stage pancreatojejunostomy are recommended surgical procedures for patients undergoing major hepatectomy with pancreatoduodenectomy, especially when concomitant vascular resection is required for curative resection of the tumor in patients with a soft pancreatic parenchyma and thin pancreatic duct.: 1996 by the Société Internationale de Chir, ugie Miyagawa Shinichi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Makuuchi Masatoshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Kawasaki Seiji First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Hayashi Ken First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Harada Haruhisa First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Kitamura Hiroshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Seki Hitoshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut https://doi.org/10.1007/s002689900014 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900014 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Miyagawa Shinichi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Makuuchi Masatoshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Kawasaki Seiji First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Hayashi Ken First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Harada Haruhisa First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Kitamura Hiroshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut NATIONALLICENCE 700 1- Seki Hitoshi First Department of Surgery, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer