Résumé
Hepatic resection for benign pathology is rare. We report our experience in two patients with hepaticolithiasis. One patient underwent left hemihepatectomy with removal of segments II, III and IV for localized Caroli's disease with multiple intrahepatic calculi. The second patient underwent resection of segment II and III with Roux-en-Y hepaticojejunostomy for right and left intrahepatic calculi with an abscess in the left lobe of the liver and a choledochal cyst.
Sujets)
Adulte , Maladie de Caroli/complications , Lithiase biliaire/complications , Femelle , Hépatectomie , Conduit hépatique commun , Humains , Maladies du foie/complications , Adulte d'âge moyenRésumé
Benefit of resection of metastatic lesions to the liver and lung from colonic cancer is well established. Resection of solitary metastasis or of locally recurrent malignancies in the periampullary region has now become the norm, as it increases survival. We present our experience with two patients with metastases in the periampullary region from previously treated colonic carcinoma who were treated with pancreaticoduodenectomy.
Sujets)
Adénocarcinome/secondaire , Tumeurs du côlon/anatomopathologie , Tumeurs du duodénum/secondaire , Femelle , Humains , Mâle , Adulte d'âge moyen , Tumeurs du pancréas/secondaire , DuodénopancréatectomieRésumé
OBJECTIVES: To assess the morbidity, mortality and 1- and 2-year survival rates, and safety of pancreaticoduodenectomy for periampullary (including pancreatic head) carcinomas in a non-oncology surgical set-up. METHODS: Records of 45 patients undergoing pancreaticoduodenectomies for periampullary cancers between July 1996 and April 2000 were reviewed. These included ampullary (n=23), pancreatic (14) and duodenal (2) adenocarcinomas, lower-end cholangiocarcinoma (5), and ampullary carcinoid (1). Thirty-seven patients underwent the Whipple procedure and 8 underwent the pylorus-preserving modification. RESULTS: The overall mortality rate was 11% and morbidity rate was 46%. Wound infection was the most common postoperative complication. The 1- and 2-year survival rates for periampullary cancers were 61% and 39% and those for pancreatic cancers were 57% and 36%, respectively. CONCLUSION: Pancreaticoduodenectomy for periampullary tumors remains a formidable procedure in our set-up. However, it can be performed safely with low mortality and morbidity rates.