title: A systematic review of safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.
abstract: OBJECTIVE
  To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.
  
  
  METHODS
  Medline and EMBASE were systematically searched for papers of hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers.
  
  
  RESULTS
  Eighteen studies involving 397 patients were reviewed. Major hepatectomy was undertaken in 81.3% of the 397 patients and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median = 31%). The 5-year survival rate in patients who underwent curative resection was 18-68.8% (median = 51.3%), and 0% in patients who received non-curative resection.
  
  
  CONCLUSIONS
  Hepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom curative resection is feasible.
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China. Electronic address: zhouymsxy@sina.cn.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
authors.forename: Zuobing
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
authors.forename: Lupeng
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
mesh_terms: D000368:Aged; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome