ABSTRACT
Results of surgical treatment of 346 patients with cancer of the stomach are presented. All the patients underwent extended D2 and D3 lymphadenectomy. Up-to-date aspects of surgical treatment of stomach cancer, including intraoperative staging of cancer, spectrum of surgeries, their technical features, postoperative complications, lethality are outlined. Extended lymphadenectomy increases insignificantly time of surgery, rate of postoperative complications, postoperative lethality compared with standard surgeries in cancer of the stomach.
Subject(s)
Gastrectomy/methods , Lymph Nodes/surgery , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Adult , Aged , Female , Gastrectomy/adverse effects , Gastrectomy/mortality , Humans , Lymph Node Excision , Male , Middle Aged , Neoplasm Invasiveness/diagnosis , Peritoneal Cavity/surgery , Stomach Neoplasms/diagnosis , Treatment OutcomeABSTRACT
Data on 148 cases of cancer of the gallbladder and extrahepatic bile ducts were studied. Jaundice proved the cardinal symptom. No clear-cut clinical picture of the disease was identified. Diagnostic procedure should start with ultrasonography. Cholangiectasia and the enlarged pancreatic head make the case for fiber bronchoscopy and hypotonic duodenography. Cancer-negative patients should further undergo transcutaneous transhepatic cholangiography and, if proving still negative, retrograde cholangiopancreatography. Resection of bile ducts with simultaneous lymphadenectomy is considered radical. The authors suggest a surgical procedure for cancer of the gallbladder which includes resection of the liver, hepatico-choledoctomy and cholecystectomy with formation of cholangio-jejuno-anastomosis using disposable transhepatic drains. Recanalization of bile ducts by transhepatic drain is considered optimal for palliation. Survival depends upon extent of surgery and level of bile duct obstruction.
