Manipal Hospital Bhubaneswar Successfully Performs Rare Dual HPB (Hepato-Pancreato-Biliary) Cancer Surgery

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Bhubaneshwar, 22nd November 2024 – A team of expert surgeons and oncologists at Manipal Hospital Bhubaneswar achieved a ground-breaking feat by successfully treating a 65-year-old woman diagnosed with two simultaneous malignancies—gallbladder cancer and pancreatic head cancer. This rare combination, seen in less than 1% of patients globally, typically presents a significant surgical challenge and is often deemed inoperable by most medical centers.

The patient initially came with abdominal pain to Dr Pratap Behera, Sr Consultant Medical Gastroenterologist and diagnostic imaging revealed a gallbladder tumor along with a mass over the pancreas. While the pancreatic mass was suspected to be metastatic spread from the gallbladder cancer, further evaluation with a whole-body PET scan ruled out metastasis. This unique finding pointed to dual malignancies—a rare scenario requiring specialized intervention.

Knowing the complexity of the case, a multidisciplinary Tumor Board discussion led by Dr. Jyotirmay Jena, Consultant in GI and HPB Surgery, Dr. Nitish Acharya, Consultant – Surgical Oncologist, and Dr. Sachin Sekhar Biswal, Medical Oncologist, decided on a curative radical surgery followed by adjuvant chemotherapy.

Unprecedented Surgical Milestone

Dr. Jena and his team performed an intricate Hepato-Whipple’s procedure, which is about

• Radical cholecystectomy with resection of liver segments 4b and 5

• En bloc Whipple’s pancreato-duodenectomy

• Extensive lymphadenectomy

The reconstruction phase posed significant challenges due to the non-dilated bile duct and pancreatic duct measuring approximately 1 mm. Despite these hurdles, the surgery was successfully completed with no postoperative complications. The patient was discharged just 10 days later in stable health and has now commenced adjuvant chemotherapy.

Surgery remains the cornerstone of treatment for GI and HPB cancers. Without it, curative outcomes are not possible,” said Dr. Jyotirmay Jena, Senior Gastro and HPB Surgeon. “This case highlights the importance of a multidisciplinary approach and meticulous planning in successfully addressing even the most advanced and complex cancers.

Department of Gastro sciences at Manipal Hospital deals with all advanced endoscopic & surgical procedures to treat complex GI & HBP diseases and Cancers includes advances Endoscopic procedure, ERCP, Palliatinemetallic stenting(SEMS), advanced Laparoscopic surgery for GI cancers and complex Hepato-Biliary and pancreatic surgery.

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