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The incidence and epidemiology of gallbladder cancer in Qatar
S174
ePoster Abstracts
P140 INCIDENTAL GALLBLADDER CARCINOMA AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN UNIVERSITY HOSPITAL IN PLZEN BETWEEN 2005 AND 2015 V. Treska, J. Fichtl, V. Liska and A. Skalicky Charles University Prague, University Hospital Pilsen, Pilsen, Czech Republic Objective: The aim of the study is retrospective analysis of 34 patients who underwent surgery for accidental gallbladder carcinoma after laparoscopic cholecystectomy in University Hospital in Plzen between 2005 and 2015. Methods: The group of 34 patients after laparoscopic cholecystectomy with accidental carcinoma final histology was analysed. All of them underwent radical cholecystectomy in our institution. Results: We have 0% postoperative mortality, morbidity was 42%. The most common complication was collection of fluid and right side fluidothorax. The average 5 year survival was in our group 68%, of course it was dependent on tumor staging. Conclusion: Due to early stage of malignant disease in accidental gallbladder carcinoma after laparoscopic cholecystectomy the prognosis can be very good if the treatment is radical and is performed in high volume centers.
P141 THE INCIDENCE AND EPIDEMIOLOGY OF GALLBLADDER CANCER IN QATAR I. Sulieman, M. Al-Dhaheri, M. Abu-Nuwar, K. Ahmed, W. Elmoghazy, A. Elaffandi and H. Khalaf Hamad General Hospital, Doha, Qatar Objective: To study the incidence and epidemiology of Gallbladder cancer in Qatar. Methods: This is a retrospective analysis of the cases of gallbladder cancer in Hamad General Hospital in Qatar from 2009 to 2016. Results: 37 patients presented with gallbladder cancer in the period of the study, 10 females (27%) and 27 males (73%). 14 patients (37.8%) were diagnosed incidentally after laparoscopic cholecystectomy, 16 (43.2%) were diagnosed pathologically, and 4 patients were diagnosed radiologically. The mean age at the time of diagnosis is 53 years (31e 78). 70% of disease occurred in patients less than 60 years old when compared to other age groups. Metastatic disease was discovered in 25 patients (67.6%) versus no metastasis in 12 patients (32.4%). The most common sites for metastasis were the liver (64%), peritoneum (36%), and lymph nods (36%). Curative resection was done in 9 patients (8-Central resection, 1-Extended right hepatectomy). Histopathology showed adenocarcinoma in 33 patients (89.1%), neuroendocrine tumor in 3 patients (8.1%) and high-grade dysplasia in 1 patient (2.7%). 33 patients have regular follow up (up to 7 years), with 26 still alive. 4 patients died during follow up with survival after diagnosis from 1 month to 2 years. Conclusion: In Qatar, due to the unique demographics, gallbladder cancer is more common in males and in younger age groups. Most of the patients present late with
metastasis, but curative resection is associated with longterm survival.
P142 CAVOATRIAL THROMBECTOMY FOR ABDOMINAL TUMORS WITHOUT CARDIOPULMONARY BYPASS. SINGLE CENTRE EXPERIENCE AND STATE OF THE ART Y. Quijano, B. Ielpo, H. Duran, R. Caruso, E. Diaz, I. Fabra, L. Malave, V. Ferri, S. Lazzaro, D. Kalivaci, L. Manino and A. Zafra Sanchinarro University Hospital, Madrid, Spain Objective: Surgical resection of a tumor with thrombus formation extending from the inferior vena cava (IVC) to the right atrium can be performed without the use of a cardiopulmonary bypass. However, this technique is not widely known or used by general surgeons. Our aim was to present our single centre experience and a literature review. Methods: Retrospective analysis of 3 cases with successful cavoatrial thrombectomy without the use of cardiopulmonary bypass by a transabdominal, transdiaphragmatic, and transpericardic approach. We also performed a review of the English literature of this procedure. Results: Three cases are presented: right-sided hepatocellular carcinoma, a right renal carcinoma, and a recurrent hepatic hydatid cyst all which required surgery. An approach from the right atrium to the IVC was used, and then, after cavoatrial occlusion, a cavotomy was performed to carry out the thrombectomy. In all cases, a transesophageal echocardiography was performed during surgery. We only found 6 other similar cases that were performed successfully in current medical literature. Conclusion: Our own experiences and cases identified through a literature review demonstrate that a thrombectomy for IVC thrombus in the setting of abdominal pathology can be performed successfully in selected cases without the support of cardiopulmonary bypass.
P144 COMPARISON OF SPECTRUM OF COMPLICATIONS AFTER PANCREATICODUODENECTOMY IN PATIENTS WITH OR WITHOUT PREOPERATIVE BILIARY DRAINAGE H. Poudel, T. Yadav, V. Gupta, R. Kochhar, S. Sinha and V. Singh BPKIHS, Dharan, Nepal Objective: Preoperative Biliary Drainage had a conflicting role in resectable periampullary carcinoma with regard to post-operative complications. The debate has surfaced again with use of neoadjuvant chemotherapy for periampullary tumors. We performed prospective study to evaluate outcomes of surgery in patients who have undergone pancreaticoduodenectomy with or without preoperative biliary stents in terms of morbidity and mortality. Methods: Patients who underwent pancreaticoduodenectomy with or without PBD were followed prospectively for post-operative morbidity and mortality. Study was done in
HPB 2017, 19 (S1), S120eS192
ePoster Abstracts
P140 INCIDENTAL GALLBLADDER CARCINOMA AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN UNIVERSITY HOSPITAL IN PLZEN BETWEEN 2005 AND 2015 V. Treska, J. Fichtl, V. Liska and A. Skalicky Charles University Prague, University Hospital Pilsen, Pilsen, Czech Republic Objective: The aim of the study is retrospective analysis of 34 patients who underwent surgery for accidental gallbladder carcinoma after laparoscopic cholecystectomy in University Hospital in Plzen between 2005 and 2015. Methods: The group of 34 patients after laparoscopic cholecystectomy with accidental carcinoma final histology was analysed. All of them underwent radical cholecystectomy in our institution. Results: We have 0% postoperative mortality, morbidity was 42%. The most common complication was collection of fluid and right side fluidothorax. The average 5 year survival was in our group 68%, of course it was dependent on tumor staging. Conclusion: Due to early stage of malignant disease in accidental gallbladder carcinoma after laparoscopic cholecystectomy the prognosis can be very good if the treatment is radical and is performed in high volume centers.
P141 THE INCIDENCE AND EPIDEMIOLOGY OF GALLBLADDER CANCER IN QATAR I. Sulieman, M. Al-Dhaheri, M. Abu-Nuwar, K. Ahmed, W. Elmoghazy, A. Elaffandi and H. Khalaf Hamad General Hospital, Doha, Qatar Objective: To study the incidence and epidemiology of Gallbladder cancer in Qatar. Methods: This is a retrospective analysis of the cases of gallbladder cancer in Hamad General Hospital in Qatar from 2009 to 2016. Results: 37 patients presented with gallbladder cancer in the period of the study, 10 females (27%) and 27 males (73%). 14 patients (37.8%) were diagnosed incidentally after laparoscopic cholecystectomy, 16 (43.2%) were diagnosed pathologically, and 4 patients were diagnosed radiologically. The mean age at the time of diagnosis is 53 years (31e 78). 70% of disease occurred in patients less than 60 years old when compared to other age groups. Metastatic disease was discovered in 25 patients (67.6%) versus no metastasis in 12 patients (32.4%). The most common sites for metastasis were the liver (64%), peritoneum (36%), and lymph nods (36%). Curative resection was done in 9 patients (8-Central resection, 1-Extended right hepatectomy). Histopathology showed adenocarcinoma in 33 patients (89.1%), neuroendocrine tumor in 3 patients (8.1%) and high-grade dysplasia in 1 patient (2.7%). 33 patients have regular follow up (up to 7 years), with 26 still alive. 4 patients died during follow up with survival after diagnosis from 1 month to 2 years. Conclusion: In Qatar, due to the unique demographics, gallbladder cancer is more common in males and in younger age groups. Most of the patients present late with
metastasis, but curative resection is associated with longterm survival.
P142 CAVOATRIAL THROMBECTOMY FOR ABDOMINAL TUMORS WITHOUT CARDIOPULMONARY BYPASS. SINGLE CENTRE EXPERIENCE AND STATE OF THE ART Y. Quijano, B. Ielpo, H. Duran, R. Caruso, E. Diaz, I. Fabra, L. Malave, V. Ferri, S. Lazzaro, D. Kalivaci, L. Manino and A. Zafra Sanchinarro University Hospital, Madrid, Spain Objective: Surgical resection of a tumor with thrombus formation extending from the inferior vena cava (IVC) to the right atrium can be performed without the use of a cardiopulmonary bypass. However, this technique is not widely known or used by general surgeons. Our aim was to present our single centre experience and a literature review. Methods: Retrospective analysis of 3 cases with successful cavoatrial thrombectomy without the use of cardiopulmonary bypass by a transabdominal, transdiaphragmatic, and transpericardic approach. We also performed a review of the English literature of this procedure. Results: Three cases are presented: right-sided hepatocellular carcinoma, a right renal carcinoma, and a recurrent hepatic hydatid cyst all which required surgery. An approach from the right atrium to the IVC was used, and then, after cavoatrial occlusion, a cavotomy was performed to carry out the thrombectomy. In all cases, a transesophageal echocardiography was performed during surgery. We only found 6 other similar cases that were performed successfully in current medical literature. Conclusion: Our own experiences and cases identified through a literature review demonstrate that a thrombectomy for IVC thrombus in the setting of abdominal pathology can be performed successfully in selected cases without the support of cardiopulmonary bypass.
P144 COMPARISON OF SPECTRUM OF COMPLICATIONS AFTER PANCREATICODUODENECTOMY IN PATIENTS WITH OR WITHOUT PREOPERATIVE BILIARY DRAINAGE H. Poudel, T. Yadav, V. Gupta, R. Kochhar, S. Sinha and V. Singh BPKIHS, Dharan, Nepal Objective: Preoperative Biliary Drainage had a conflicting role in resectable periampullary carcinoma with regard to post-operative complications. The debate has surfaced again with use of neoadjuvant chemotherapy for periampullary tumors. We performed prospective study to evaluate outcomes of surgery in patients who have undergone pancreaticoduodenectomy with or without preoperative biliary stents in terms of morbidity and mortality. Methods: Patients who underwent pancreaticoduodenectomy with or without PBD were followed prospectively for post-operative morbidity and mortality. Study was done in
HPB 2017, 19 (S1), S120eS192