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Cirrhosis should not be considered as an absolute contraindication for pancreatoduodenectomy

David Fuks1, Charles Sabbagh, Thierry Yzet

  • 1Department of Digestive Surgery, Jules Verne University of Picardy, Amiens, France.

Hepato-Gastroenterology
|April 4, 2012
PubMed

Insights

Pancreaticoduodenectomy (PD) can be safely performed in select patients with Child A liver cirrhosis. This study presents four successful cases, challenging the traditional contraindication for PD in cirrhotic patients.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Oncology

Background:

  • Liver cirrhosis is traditionally considered a contraindication for pancreaticoduodenectomy (PD).
  • This perception may limit treatment options for cirrhotic patients with pancreatic or periampullary tumors.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of pancreaticoduodenectomy (PD) in patients with liver cirrhosis.
  • To present a series of successful PD cases in cirrhotic individuals.

Main Methods:

  • Retrospective review of 4 patients with liver cirrhosis who underwent pancreaticoduodenectomy (PD) between 2004 and 2008.
  • All patients were Child Pugh A without portal hypertension, confirmed histologically for cirrhosis.

Main Results:

  • Four patients (3 males, 1 female; age 53-66) underwent PD for pancreatic head adenocarcinoma or ampullary carcinoma.
  • No postoperative mortality was observed, though complications included ascites, pancreatic fistula, and pulmonary infection.
  • Median survival was 12.5 months, with 3 patients alive and disease-free post-surgery.

Conclusions:

  • Pancreaticoduodenectomy (PD) in patients with Child A liver cirrhosis should not be systematically considered a contraindication.
  • Careful patient selection and management may allow for successful PD in this population.
Abstract

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