Synchronous Liver Metastasis Should not be an Absolute Contraindication for Curative Pancreaticoduodenectomy: A Report of 3 Cases with Good Long-term Survival

Background Ductal adenocarcinoma of the pancreatic head is an aggressive cancer with poor prognosis. Surgery offers the only means of cure but most patients are often inoperable at diagnosis due to concomitant metastasis. Although many authors have explored the role of surgery in these patients there is no reported long-term survival. Case presentation The salient features of the clinical presentation, surgical management and long-term outcomes of patients who underwent simultaneous pancreaticoduodenectomy and resection of liver metastases associated with peri-operative chemotherapy are presented and discussed. We report three patients who have survived more than five years after undergoing surgery with curative intent of metastatic pancreatic head adenocarcinoma. Conclusion The salient feature of these patients is that the metastases were limited to the liver with good response to chemotherapy. One patient in particular is considered to be cured. This strategy offers a chance of prolonged survival and even cure compared to palliative chemotherapy.