Objective To evaluate the effect of extended local resection for the treatment of periampullary carcinoma of Vater. Methods The extrahepaticobiliary tract, confluence of pancreatic and biliary duct, Vater ampulla and duodenal papilla was resected en bloc in 8 cases suffering from periampullar carcinoma from 1995 to 1998. Results One patient died perioperatively. Duodenal obstruction developed postoperatively in one patient was relieved by reoperation. All 7 cases were followed up for more than 6 months without recurrence.Conclusions This extended local resection fulfils the purpose of radical therapy for the treatment of periampullar maliganancy.

Objective To explore the clinical selection of surgical methods for pure stenosis at the end of the common bile duct.Methods The clinical data of 43 cases of pure stenosis at the end of the common bile duct treated in this hospital from October 2003 to June 2009 were retrospectively analyzed.Of the 43 cases, 12 underwent endoscopic sphincterotomy(EST), 9 sphincteroplasty of Oddi, 5 pancreaticoduodenectomy,8 Roux-en-y choledochojejunostomy and 5 choledocoduodenostomy,4 underwent drainage of the T tube after exploration of the biliary passage.Results Among 37 patients did not undergo the radical pancreaticoduodenectomy,6 had space-occupying lesions 5-19 months postoperatively.Five of them received pancreaticoduodenectomy again.Conclusion Pure stenosis at the end of the common bile duct should be carefully managed.