An Analysis Of Surgical Treatment For 139 Cases With Peri-ampulla Carcinoma.

Objective: To summarize the methods of diagnosis and surgery and their factors influence of the resection rate of peri- ampulla carcinomas. Methods: Retrospective analysis of the clinical data of 139 patients with peri-ampulla carcinoma were diagnosed and operated in our department from January 1994 to January 2005, 109 cases with carcinoma of head of pancreas and 30 cases with carcinoma of ampulla. Results: Preoperative qualitative veracity for the tumors was 81.6%(111/136) for BUS,89.3%(68/73) for CT(CTA),93.2%(68/73) for MRI(MRCP), 68.4% (13/19) for ERCP,83.2%(15/17) for PTC, while the actual removability was 71.9%(41/57) for BUS,84.8%(38/46) for CT(CTA), 94.3%(32/35) for MRI(MRCP), 63.6%(7/ll)for ERCP, 66.7%(8/12) for PTC. The overall resection rate was 30.9%. The resection rate for pancreas carcinoma in head and carcinoma of ampulla were 23.9% and 56.7% respectively. The morality of Pancreatoduodenectomy was 9.3%(4/43) and the operative complication morbidity 37.2%(16/43).The main complication in the above groups were pancreatic fistula(7%,3/43), biliary fistula(9.3%,4/43), bleeding(7%,3/43), abdominal infection (9.3%,4/43). If with short history, or younger,or tumor size was less than 3cm, or without marasmus,or vessel invasion and or no distance metastasis had higher resection rate. Conclusion: Combined adoption of the current advanced imagingmethods could result in increasing early diagnosis and essential for accurate determination of tumor respectability and operation designing. Therefore, it could improve the resection rate, decrease the operative mortality, complication morbidity.