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KMID : 0870419970010010105
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1997 Volume.1 No. 1 p.105 ~ p.112
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The Short-term Results of Hepatic Resection for Proximal Bile Duct Tumor Patients
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Choi Dong-Wook
Paik Nam-Sun
Moon Nan-Mo
Lee Byung-Hee
Cho Kyung-Ja
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Abstract
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Background: Hepatic resection for proximal bile duct tumor(PBDT) is still a challenging procedure. Recently, encouraging results were reported from several centers with regard to postoperative morbidity and mortality as well as survival.
Aim: To evaluate the resectability and postoperative morbidity and mortality following hepatic resection for PBDT and to evaluate accuracy of intraoperative fronzen section to get tumor free margin.
Materials and Methods: 5 men and 6 women underwent hepatic resection for PBDT from Mar. 1994 to Sept. 1996 in KCCH. 3 cases of right lobectomy, 2 cases of extended right lobectome(ERL), 3 cases of ERL plus caudate lobectomy and 3 cases of hepaticopancreatoduodenectomy(HPD) were performed after biliary drainage.
Results: Most of postoperative complications had pulmonary origins and 1 patient suffering from pneumonia expired at postoperative 32nd day due to ARDS, so mortality rate was 9.1%(1/11). Atypical cells were seen at 6 sites
of resection margin, but only 2 sites were proven to have been invaded by cancer cells through postoperative permanent section.
Conclusion: Both high resectability and pathologically curative resection rates can be obtained with combined
hepatic resection for PBDT with acceptable mortality rates through diligent pulmonary care after biliary drainage. Improvements is accuracy of intraoperative frozen section can be acquired through abundant experience and active communication with pathologist during operation.
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KEYWORD
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Proximal bile duct tumor, Hepatic resection
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