Unconventional surgery at the Central Teaching Clinical Hospital UCC MUW

In the Department of General, Gastroenterology and Oncologic Surgery of the UCC MUW a very unusual and rare surgery of simultaneous excision of the head of the pancreas and a fragment of the liver was performed in a patient who underwent hepatic transplantation in the past. 

Originally, in 2011, the patient underwent orthotopic liver transplantation in the Department of General, Transplantation and Liver Surgery of the Medical University of Warsaw, head Prof.Marek Krawczyk, where he was operated by the team of Prof. Paweł Nyckowski and Doc. Krzysztof Dudek. The indication for transplantation was primary sclerosing cholangitis.

Both immediate and distant transplantation outcome was very good.

After 9 years, thanks to systematic observation, an increase of tumor markers was noticed and a tumor was diagnosed in the pancreatic segment of the common bile duct. Doctors team from the Department of General, Gastroenterological and Oncological Surgery at UCC MUW where the patient was consulted, after evaluating the results of imaging tests and the patient's condition, decided to undertake radical surgical treatment. On the 20th of April this year the team consisting of Prof. Maciej Słodkowski, Prof. Paweł Nyckowski, Dr. Dominika Karkocha, Dr. Joanna Lisowska and Dr. Michał Korba with anaesthesiologist Dr. Renatą Kielmas, anaesthesiology nurse Elżbietą Kołodziejczyk, operating nurses Eweliną Kamińską and Mateuszem Pietrowiczem performed pancreaticoduodenectomy m.Traverso-Longmire  (pancreatic head resection with preservation of the pylorus) in one block with a fragment of 1st liver segment and radical lymphadenectomy around the hepatic and superior mesenteric arteries.

According to the latest scientific reports, radical surgical treatment of such patients is extremely rare and poses a very big technical challenge. No complications were observed in the postoperative course, the patient in good condition was discharged home.

Photo: Department of General, Gastroenterology and Oncologic Surgery