[Pancreaticoduodenectomy combined with multivisceral resections]

Locally advanced tumors of the stomach, colon and hepatopancreatobiliary zone comprise more than 20% of all cancers. Treatment of these patients is difficult, since tumors have complications in more than 70% of cases. Appropriate treatment poses difficulties due to functional state of these patients. Despite the success of drug therapy, multivisceral R0 resections including pancreaticoduodenectomy for locally advanced tumors of the stomach, right half of the colon and hepatopancreatobiliary organs, are the only way to improve survival of such patients. This review is devoted to the largest studies of multivisceral resections, including pancreaticoduodenectomy for locally advanced cancer of the stomach, right half of the colon and hepatopancreatobiliary tumors. The immediate and long-term results of treatment, as well as prognostic factors of survival are presented. Currently, all available articles are presented by case reports or series of cases. Meta-analysis of several retrospective studies is rare. The indications for such extensive surgical interventions are not defined. Prospective and randomized studies are almost impossible due to extremely heterogeneous groups.