Surgical Therapy for Gastric Cancer with Hepatic Cirrhosis

Kim, Young Hoon; Bae, Sung Woo; Kim, Hyung Ho; Choi, Hong Jo; Cho, Se Heon; Jung, Gab Jung; Lee, Yong Eon; Kim, Sang Soon

Abstract

BACKGROUND: The prognosis following surgery for gastric cancer has been markedly improved as a result of early diagnosis and advancements both in operative techniques and perioperative management. However, gastrointestinal surgery in the presence of hepatic cirrhosis has shown high operative morbidity and mortality due to severe perioperative complications, such as bleeding, lymphorrhea, anastomosis leakage, hepatic failure, fluid retention, acute renal failure, and multiple organ failure. Recently, the number of gastric-cancer patients patient who has liver cirrhosis has been increasing, especially for early gastric-cancer cases.
METHODS
From June 1995 to December 1997, a total of 410 patients with gastric cancer were treated surgically in our degartment.
RESULTS
Of the 410, 9 cases with liver cirrhosis underwent a gastric resection: 5 standard subtotal gastrectomies and 4 curative subtotal gastrectomies. Three major postoperative complications occurred in 2 patient: anastomosis leakage in one and bleeding in both.
CONCLUSIONS
The purpose of this study was to report our complicated cases, to assess the causes of the complications, and to decide the appropriate operation type for improving the prognosis of these patients. Serosal flap can be the solving techniques in B-I anastomosis and complicated perforation in cirrhosis.