HEPATOBILIARY CANCER - SURGICAL CONSIDERATIONS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 56  (11) , 686-699
Abstract
Most cancers of the hepatobiliary system will have grown beyond the limits of curative resection by the time they become clinically evident. This reality has fostered therapeutic nihilism; most physicians and surgeons in their pessimism have failed to study the early modes of spread of these tumors, patterns of growth that are relevant to proper treatment of those patients who do have lesions that can be removed with hope of achieving a cure. Anatomic and technical complexities may beget surgical reluctance in the management of potentially curable lesions. Therefore, this review is offered for orientation and perspective for those who would hope to offer optimal treatment for patients who have primary cancers of the liver, gallbladder or biliary ducts. The review includes considerations of surgical anatomy, modes of spread, assessment of resectability, surgical technique and results of operative treatment in relation to curative resection. Also offered are some guides to palliative surgical management of tumors that have reached the hepatic hilus.