Iterative Hepatectomy for Recurrent Cancer. New Way for Radical Surgery for Recurrent Gallbladder Carcinoma

Introduction: Iterative hepatectomy for recurrent gallbladder cancer was not reported yet. Radical surgery of gallbladder carcinoma is still modest for almost cases advanced gallbladder which is the majority of this disease. Radical surgery is possible only for 15% of patients. We have realised 4 cases of hepatectomy for a recurrent tumours. Materials and Methods: The first patient was 42 year-old woman who had bisegmentectomy IV-V and extensive lymphadenectomy and associated to anther bisegmental VI-VII at 24 months on postoperative path. The second patient woman aged of 48 year-old has had Glenn and bisegmentectomy IV-V for recurrence 2 years after. The third case was 51 year-old woman how had operated from cholecystectomy and bisegmentectomy. After recurrence, she was operated again for metastasectomy enlarged to the diaphragm. The forth patient was a 54 year-old woman who undergoes a bisegmentectomy and lymphadenectomy. Results: A new hepatectomy was done at 10 month for a recurrent hepatic disease. A metastasectomy was done. She died at 31 month from a new hepatic metastasis. We instituted systemic adjuvant chemotherapy for all 4 cases in postoperative period. The four first patients died at 4, 6, 17, 22 months and the fifth is still alive at 3 month after a new hepatectomy. These cases illustrate thepossibility of iterative hepatectomy for recurrent gallbladder carcinoma. Conclusion: There are a few articles in literatures about recurrent gallbladder carcinoma and especially for iterative hepatectomy. This surgery must have a discussion between a surgeon and patient. Even if the mean survival is not verylong, these cases motivate us to continue in this way. With strict analysis and more elements of judgment, our hope is to improve the survival in the second phase.

Author(s): Berkane S and Bendjaballah A

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