Long‐term survival after hepatectomy for hepatic recurrence of carcinoma of the papilla of Vater

• Published in: Journal of Hepato‐Biliary‐Pancreatic Surgery Vol. 12; no. 4; pp. 321 - 323
• Main Authors: Kitami, Chi‐e, Kurosaki, Isao, Koyama, Yu, Makino, Haruhiko, Hatakeyama, Katsuyoshi
• Format: Journal Article
• Language: English
• Published: Japan 01.08.2005
• Subjects: Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adenocarcinoma, Papillary - pathology; Adenocarcinoma, Papillary - surgery; adjuvant chemotherapy; Aged; Ampulla of Vater; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; carcinoma of the papilla of vater; Chemotherapy, Adjuvant; Common Bile Duct Neoplasms - pathology; Common Bile Duct Neoplasms - surgery; Hepatectomy; hepatic metastasis; hepatic resection; Humans; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Pancreaticoduodenectomy; Tegafur - therapeutic use; Treatment Outcome; Uracil - therapeutic use
• ISSN: 0944-1166; 1868-6982; 1436-0691
• DOI: 10.1007/s00534-005-0972-5

We present herein a rare case of a long‐term survivor after major hepatectomy performed for a metastatic liver tumor from carcinoma of the papilla of Vater. A 74‐year‐old man had undergone a pancreaticoduodenectomy for carcinoma of the papilla of Vater with obstructive jaundice, in April 1995. Histologically, an exposed mass‐forming type of tumor, measuring 40 × 30 mm, was composed of mucinous and papillary adenocarcinoma, invading into the muscularis propria of the duodenum, without lymph node metastases. The patient did not receive any type of chemotherapy. In September 1999, a solitary hepatic tumor, 3.5 cm in diameter, was detected in segment VIII of the liver by computed tomography. In November 1999, right hepatic lobectomy was carried out. The anterior and posterior portal pedicles were ligated and dissected in the hepatic parenchyma so as not to compromise the hepaticojejunostomy. After the hepatectomy, the patient was treated with low‐dose tegafur/uracil/cisplatin therapy for approximately 2 years. He has been doing well, without recurrence, for 5 years after the hepatectomy. Hepatectomy for hepatic metastases from carcinoma of the papilla of Vater is thought to be a useful surgical treatment in selected patients.