The patient has been disease-free for 14 months. Innovative surgery at Zhongshan Hospital revealed thousands of liver metastases from pancreatic tumors.
A tumor that originated in the pancreas spreads to the liver and forms thousands of tumors of various sizes, endangering the patient's life. Can it still be treated with surgery? Recently, a multidisciplinary team of experts on pancreatic tumors at Zhongshan Hospital successfully performed the country's first post-conversion therapy "orthotopic liver transplantation combined with total pancreatectomy" surgery with superb medical skills and close collaboration, igniting hope for the patient Mr. Wang's rebirth.
In July 2021, Mr. Wang was diagnosed with pancreatic neuroendocrine tumors accompanied by extensive liver metastases, including more than a thousand liver tumors. These tumor cells secrete excessive hormones, causing him to suffer from severe diarrhea. Continued water loss and electrolyte imbalance can cause organ damage and failure, which can be life-threatening. The doctor at the gastroenterology department of Zhongshan Hospital immediately contacted the experts from the pancreatic tumor multidisciplinary clinic for consultation.
Expert introduction: For patients with pancreatic cancer, complete tumor resection is the only hope for long-term survival. However, according to Mr. Wang's actual condition, he was not yet qualified for surgery at that time. The team formulated multiple combined and sequential treatment strategies such as "chemotherapy-targeted immune intervention" for him to first relieve symptoms and control tumor growth.
After 15 months of joint efforts by both doctors and patients, Mr. Wang's condition improved significantly, the lesions on his pancreas and liver shrank, and the malignancy of the tumor decreased. He finally had the opportunity for surgical treatment.
"After repeated studies and judgments, the multidisciplinary team believes that 'orthotopic liver transplantation combined with total pancreatectomy' surgical treatment can be performed." Professor Liu Liang, director of pancreatic surgery, explained that the patient's tumor has extensively affected the pancreas and liver, and the relationship between these two organs is The disease states are closely connected, like two important strongholds on the battlefield. Staged surgery can result in the tumor getting worse or spreading again while the patient is waiting to recover from the second surgery, undoing all the work done.
However, liver transplantation and pancreatic tumor surgery are both difficult and high-risk operations in abdominal surgery. Choosing a treatment plan that solves both problems at once is a huge challenge for the surgical team.
After sufficient preoperative preparation, the medical team performed the surgery on Mr. Wang on February 3, 2023. The team of Professor Zhou Jian, Executive Vice President and Director of Liver Oncology Surgery of Zhongshan Hospital, accurately removed the diseased liver and carefully anastomized the blood vessels and bile ducts of the donor and recipient.
As the blood flow is restored, bile will flow out of the "transplanted liver". Immediately afterwards, Professor Liu Liang's team from the Department of Pancreatic Surgery worked in succession, cleverly avoiding the complex blood vessels around the pancreas, and successfully completed the total pancreatectomy. With the assistance of the anesthesiology department and the operating room nursing team, the 10-hour operation was successfully completed. After careful diagnosis and treatment by the medical staff in the intensive care unit and ward, Mr. Wang recovered well and was discharged from the hospital on April 28.
On the eve of May Day this year, the results of Mr. Wang's follow-up examinations were all good. Now he has lived without cancer for 14 months and has fully returned to his daily life.
It is reported that liver metastasis is the main cause of death in patients with pancreatic tumors, and it is also the difficulty and pain point in current diagnosis and treatment. The Pancreatic Surgery Department of Zhongshan Hospital has long been committed to the research of liver metastasis of pancreatic tumors, and as the only unit in China participated in the writing of the 2023 international expert consensus. The innovative "surgery-centered" comprehensive diagnosis and treatment model has enabled the patient's one-year survival rate to reach 92.4%, ranking among the highest in the country.
This is the first "orthotopic liver transplantation combined with total pancreatectomy" surgery performed in conjunction with liver surgery after conversion therapy, providing a new way for patient treatment. In the near future, Zhongshan Hospital will also open the country's first multidisciplinary joint clinic for liver metastasis from bile and pancreatic tumors, bringing hope to more patients.
