November 12, 2014
Notes: Tsang, Siu Wai
Yung, Ken Kin-Lam
Research Support, Non-U.S. Gov’t
PLoS One. 2013 Dec 3;8(12):e82201. doi: 10.1371/journal.pone.0082201. eCollection 2013.
Author Address: School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China.
Reference Type: Journal Article
Record Number: 4802Author: Tsuchikawa, T., Hirano, S., Tanaka, E., Kato, K., Matsumoto, J., Noji, T. and Shichinohe, T.
Title: Operative and perioperative management experience for hepatobiliary malignancies following ERCP-related pancreatitis
Short Title: Operative and perioperative management experience for hepatobiliary malignancies following ERCP-related pancreatitis
Alternate Journal: Hepato-gastroenterology
ISSN: 0172-6390 (Print)
Accession Number: 24298570
Ampulla of Vater
Bile Duct Neoplasms/*surgery
Bile Ducts, Extrahepatic
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
Common Bile Duct Neoplasms/surgery
Abstract: BACKGROUND/AIMS: There have been few papers on how to treat hepatobiliary malignancies after ERCP-related pancreatitis focusing on the timing of the operation and postoperative complications. The aim of this study was to clarify the relationship among the time after the pancreatitis, the complexity of the operation, and the characteristic postoperative complications. METHODOLOGY: The clinicopathological characteristics of five patients with hepatobiliary malignancies who had a prior history of ERCP-related pancreatitis were analyzed. RESULTS: The five patients included two with extrahepatic bile duct carcinomas, two with ampulla of Vater carcinomas, and one with intrahepatic hilar cholangiocarcinoma. The median time to the operation from pancreatitis was 31 (16-116) days. The median operation time and blood loss were 661 (576-924) min and 3695 (2730-7240) mL, respectively. Various postoperative complications were seen in all cases including acute respiratory distress syndrome and infection of peripancreatic necrosis. The postoperative mortality rate was 0%, with a morbidity rate of 100%. R0 operations were performed in all five cases. CONCLUSIONS: Surgery for hepatobiliary malignancies after ERCP-related pancreatitis appears to have a high morbidity rate. The surgery must strike a balance between curability of the malignancy and safety with respect to the frequent postoperative complications.