title: Major hepatopancreatoduodenectomy with simultaneous resection of the hepatic artery for advanced biliary cancer.
abstract: BACKGROUND
  Major hepatopancreatoduodenectomy (HPD) with simultaneous resection of the hepatic artery (HA) for biliary cancer is the most extended surgery for obtaining curative resection, and its clinical significance is unclear. The aim of this study was to appraise the clinical value of this extended procedure as a treatment for biliary cancer.
  
  
  METHODS
  We retrospectively reviewed the medical records of 38 patients with biliary cancer who underwent major HPD from 1994 to 2014. Clinicopathological factors and survival following HPD were compared between patients with and without simultaneous resection of the HA.
  
  
  RESULTS
  Of the 38 study patients, 12 patients (32 %) underwent major HPD with HA. There was no significant difference in major complications between the two groups. The overall 2-year survival rate and the median survival time following major HPD with HA were 71 % and 42.3 months. The survival of the patients with gallbladder cancer was significantly worse than that of the patients with bile duct cancer (p = 0.001).
  
  
  CONCLUSIONS
  Major HPD with simultaneous resection of the HA can be a preferable treatment option for bile duct cancer that offers acceptable perioperative morbidity and mortality, as well as long-term survival. However, this procedure for gallbladder cancer should not be performed.
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan. yasuyuki490225@yahoo.co.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukami
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaneoka
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan.
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takayama
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onoe
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Bile duct cancer; Gallbladder cancer; Hepatic artery resection; Hepatopancreatoduodenectomy