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BACKGROUND:?Chronic?liver?disease?has?been?considered?a?contraindication?to?radical?surgery?for?intra-abdominal?tumors?because?of?the?risk?of?decompensation. METHODS:?In? a? retrospective? analysis? of? all? patients?undergoing?pancreaticoduodenectomy?for?cancer?treated?from?January?2000?to?December?2006?at?our?center,?4?patients?were?identiifed?with?operable?pancreatic?tumors?and?well-compensated?chronic?liver?disease.?The?preoperative?staging,? decompression? of? the? biliary? tree,? liver? biopsy,?Child-Turcot-Pugh?and?MELD?scores?were?described. RESULTS:?All?patients?underwent?pancreaticoduodenectomy?successfully? with? minimal? blood? loss,? and? no? peri-operative? blood? transfusions? or? liver? decompensation.?There? was? no? postoperative? mortality.? Two? patients?received?adjuvant?chemotherapy.?One?patient?died?with?recurrent?disease?at?18?months,?one?is?alive?with?disease?recurrence,?and?two?are?alive?and?disease?free. CONCLUSION:?Patients?with?pancreatic?cancer?and?well-compensated? chronic? liver? disease? should? routinely? be?considered?for?radical?surgery?at?specialist?hepatobiliary?centres?with?expertise?available?to?manage?complex?liver?disease.