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Long-term survival after hepatectomy for hepatic recurrence of carcinoma of the papilla of Vater
Authors:Chi-e Kitami  Isao Kurosaki  Yu Koyama  Haruhiko Makino  Katsuyoshi Hatakeyama
Institution:Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan
Department of Surgery, Niigata Prefectural Sakamachi Hospital, Niigata, Japan
Abstract: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.
Keywords:hepatic metastasis  carcinoma of the papilla of vater  hepatic resection  adjuvant chemotherapy
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