Hepatobiliary and Pancreatic Surgery

Introduction

The recent development of various diagnostic techniques has led to the detection of an increasing number of borderline malignancies and benign tumors. Limited resection, which preserves organ function, is indicated in patients with benign or borderline malignancies. However, some diseases, such as invasive pancreatic cancer, gallbladder cancer, and hilar and intrahepatic cholangiocarcinoma, remain a difficult challenge for surgeons and are still associated with dismal long-term prognoses. Therefore, both medical and surgical oncology groups collectively treat hepatobiliary and pancreatic tumors as an integrated clinical activity. As a result, our treatment regimens have been developed as a result of close cooperation with medical oncologists and radiologists.

Clinical Activities

This Division includes 5 attending surgeons, 2 chief residents, and 4–5 residents. The outpatient clinic is open 5 days a week. We have staff meetings 3 times a week during which we discuss treatment strategies from the medical and surgical points of view. We conduct a case conference on imaging diagnosis every Tuesday in cooperation with radiologists and medical oncologists and a monthly pathology conference with pathologists
In 2007, 268 patients underwent surgical treatment at our division. The total number of patients with hepatobiliary pancreatic tumors, particularly the number of patients with pancreatic tumors, is increasing every year (Table).

● M. Konishi ●

Number of patients during 2003-2007
  2003 2004 2005 2006 2007
Hepatocellular carcinoma 69 74 75 68 63
Biliary tract cancer          
　　intrahepatic 3 5 6 8 11
　　extrahepatic 9 12 15 12 18
　　gallbladder 7 4 7 7 8
　　nonresectional surgery 2 6 3 3 1
Pancreatic tumors          
　　invasive ductal cancer 23 23 15 28 38
　　others 9 9 14 23 12
　　nonresectional surgery 3 9 10 11 15
Ampullary or duodenal cancer 10 12 10 14 8
　　nonresectional surgery 1 2 2 2 1
Liver metastasis 54 61 55 53 59
Others 24 18 19 17 34
Total 214 235 231 246 268

Table of Contents