Synchronous Resection of Solitary Liver Metastases with Pancreaticoduodenectomy

CONTEXT: There is limited information available about the feasibility and benefits of synchronous resection of liver metastases in patients with pancreatic and periampullary cancer undergoing pancreaticoduodenectomy. OBJECTIVE: We report on our experience with 7 such patients. DESIGN: Analysis of the prospective database was carried out to identify patients who underwent synchronous resection of liver metastases with pancreaticoduodenectomy. PATIENTS: Two-hundred and thirty patients underwent pancreaticoduodenectomy for pancreatic and periampullary cancer in our unit between September 2003 and September 2009. MAIN OUTCOME MEASURES: The primary aim of our study was to determine the survival benefits and the secondary aim was to evaluate their safety and influence on the results of a pancreaticoduodenectomy. RESULTS: Seven patients (3%) underwent synchronous resection of a solitary liver metastasis. In these patients, the operative time and intra-operative blood loss was marginally high as compared to the overall cohort of patients undergoing pancreaticoduodenectomy; however, the complication rates and the duration of the hospital stay were not affected. In patients undergoing resection of liver metastasis, there were 4 recurrences over a mean follow-up of 21 months. CONCLUSIONS: In patients with resectable pancreatic and periampullary cancer, the resection of a solitary liver metastasis can safely be performed together with a pancreaticoduodenectomy; however, its impact on improving survival has yet to be proven.