Experience of pancreaticoduodenectomy and the diagnosis of carcinoma of the papilla of Vater
10.3760/cma.j.issn.1007-8118.2018.07.010
- VernacularTitle:十二指肠乳头癌的诊断及胰十二指肠切除经验
- Author:
Zhenwei YE
1
;
Zaiguo WANG
Author Information
1. 南方医科大学附属东莞人民医院肝胆胰脾外科
- Keywords:
Carcinoma,papilla of vater;
Diagnosis;
Pancreaticoduodenectomy;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2018;24(7):467-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize our experience in the diagnosis and treatment of carcinoma of the papilla of Vater (CPV).Methods From April 2005 to May 2012,21 consecutive patients were enrolled in Dongguan Affiliated Hospital of Southern Medical University.The clinical characteristics,diagnosis,surgical data and follow-up results of these patients were retrospectively analyzed.Results Painless jaundice was the primary symptom in 18 patients.An elevated CEA level was observed in 3 patients preoperatively,while CA19-9 was increased in 10 patients.17 patients with periampullary tumors were detected by MRCP or CT,and in 12 patients,they were detected by ultrasound examination.Gastroscopy was performed in 16 patients,among whom 8 patients were diagnosed with neoplasm of the duodenal papilla initially,and 5 patients were ultimately diagnosed with CPV by pathological examination after biopsy.All the 21 patients were successfully treated with pancreaticoduodenectomy.8 patients developed postoperative complications.No death occurred in the perioperative period.The complications included pancreatic fistula (2 patients),gastroparesis (2 patients),incisional infection (2 patients),gastrointestinal hemorrhage (1 patient) and concurrent gastrointestinal and intraperitoneal haemorrhage (1 patient).A reoperation consisting of pancreaticoduodenal repair and drainage was performed in 1 patient.3 patients underwent adjuvant chemotherapy.Long-term follow up was obtained in 18 patients.The 1-year,3-year and 5-year survival rates were 80.9％,66.7％ and 47.6％,respectively.The longest overall survival was 152 months.Conclusions Early diagnosis of CPV was feasible.Pancreaticoduodenectomy as a treatment strategy for this cancer was safe and effective.
