National survey of hepatobiliary and pancreatic surgery in hemophilia patients in Japan

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 29; no. 3; pp. 385 - 393
• Main Authors: Yoshimoto‐Haramura, Tomoko, Hidaka, Masaaki, Hasegawa, Kiyoshi, Suzumura, Kazuhiro, Takemura, Nobuyuki, Hama, Naoki, Mizuno, Takashi, Nomi, Takeo, Kobayashi, Tsuyoshi, Sano, Keiji, Yokomizo, Hiroshi, Nitta, Hiroyuki, Kurata, Masanao, Hasegawa, Yasushi, Nagayama, Minoru, Tani, Masaji, Fukumoto, Takumi, Ohta, Masayuki, Hayashi, Hironori, Taniguchi, Hiroki, Ishino, Shinichiro, Aihara, Tsukasa, Murase, Takaaki, Tsuchida, Akihiko, Shimamura, Tsuyoshi, Marubashi, Shigeru, Kaneko, Junichi, Hara, Takanobu, Matsushima, Hajime, Soyama, Akihiko, Endo, Tomoyuki, Eguchi, Susumu
• Format: Journal Article
• Language: English
• Published: Japan Wiley Subscription Services, Inc 01.03.2022
• Subjects: Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic - pathology; cancer; Carcinoma, Hepatocellular - surgery; Hemophilia; Hemophilia A - complications; Hemophilia A - surgery; Hepatectomy; Hepatectomy - methods; hepatobiliary; Humans; Japan; Liver cancer; Liver Neoplasms - surgery; pancreas; Pancreatectomy; Pancreatic cancer; Pancreatic Neoplasms - surgery; Retrospective Studies; Surgery; Japan; hemophilia; hepatobiliary; cancer; pancreas; surgery
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.1073

Background Approximately 8300 hemophiliacs are registered in Japan, but no comprehensive reports on hepatobiliary and pancreatic surgery (HBPS) have been conducted. This report investigates the current status of HPBS in hemophilia patients in Japan. Methods The subjects were hemophiliac patients seen between January 1 2007, and December 31 2017, at facilities participating in this study among the facilities for performing high‐difficulty cases nationwide designated by the Japanese Society for HBPS. A retrospective examination of short‐term outcomes in 49 cases was conducted to assess patient background, disease, surgical procedure, and complications. Results The types of hemophilia were A: 43 cases, B: four cases, and von Willebrand disease: two cases (hemophilia severity: mild 32, moderate seven, severe 10). The target malignant diseases for surgery were hepatocellular carcinoma (HCC) in 20 cases, intrahepatic cholangiocellular carcinoma (CCC) in four cases, combined HCC‐CCC in two cases, hilar CCC in two cases, and pancreatic cancer in four cases. As for the surgical procedure, limited resection (subsegmentectomy and partial hepatectomy) was performed in 16 cases of HCC even with normal liver function tests. Pancreaticoduodenectomy and distal pacreatectomy were performed for pancreatic cancers as in the standard procedure. Postoperative complications were postoperative bleeding in two cases after hepatectomy and one after pancreatectomy in one case. When compared with Japanese National Clinical Data base, the complication rates after hepatectomy and pancreatectomy were not conspicuous in hemophilic patients. Conclusions As long as they are performed in qualified centers, complication rate is not increased in hemophilic patients undergoing HBPS. Highlight Yoshimoto and colleagues conducted a retrospective examination of short‐term outcomes of hepatobiliary and pancreatic surgery in 48 patients with hemophilia to assess the patient background, disease, surgical procedure and complications. The complication rates of hepatobiliary and pancreatic surgery performed at JSHBPS‐designated centers are not affected by the presence of hemophilia.