BACKGROUND/AIMS: Although hepatopancreatoduodenectomy with wide lymph node dissection has been conducted for patients with locally advanced gallbladder carcinoma, the clinical usefulness of this radical procedure has not yet been estimated. METHODOLOGY: Morbidity, mortality, and outcome were analyzed retrospectively for 16 consecutive patients undergoing hepatopancreatoduodenectomy. RESULTS: One in-hospital fatality (6.3%) and 11 postoperative complications occurred (69%). Overall 5-year survival in this procedure was 42.9%. The 5-year survival of patients undergoing potentially curative resection (52.7%) was significantly better (P = 0.016) than those with residual tumor (0%). There was no significant correlation in 5-year survival between patients with and without lymph node metastasis. Five patients (31%) survived 5 years. Of these, 4 had Stage IVB disease, and 2 had pN2 disease. Two patients with pM1 (lymph) disease died of the disease 6 months and the other 7 months after surgery, respectively. CONCLUSIONS: Hepatopancreatoduodenectomy with wide lymph node dissection is an effective treatment for the selected patients with locally advanced gallbladder carcinoma with until pN2 disease, if curative resection is potentially feasible. Surgery is not indicated in those with pM1 (lymph) disease.
BACKGROUND/AIMS: Although hepatopancreatoduodenectomy with wide lymph node dissection has been conducted for patients with locally advanced gallbladder carcinoma, the clinical usefulness of this radical procedure has not yet been estimated. METHODOLOGY: Morbidity, mortality, and outcome were analyzed retrospectively for 16 consecutive patients undergoing hepatopancreatoduodenectomy. RESULTS: One in-hospital fatality (6.3%) and 11 postoperative complications occurred (69%). Overall 5-year survival in this procedure was 42.9%. The 5-year survival of patients undergoing potentially curative resection (52.7%) was significantly better (P = 0.016) than those with residual tumor (0%). There was no significant correlation in 5-year survival between patients with and without lymph node metastasis. Five patients (31%) survived 5 years. Of these, 4 had Stage IVB disease, and 2 had pN2 disease. Two patients with pM1 (lymph) disease died of the disease 6 months and the other 7 months after surgery, respectively. CONCLUSIONS: Hepatopancreatoduodenectomy with wide lymph node dissection is an effective treatment for the selected patients with locally advanced gallbladder carcinoma with until pN2 disease, if curative resection is potentially feasible. Surgery is not indicated in those with pM1 (lymph) disease.