Results of surgical treatment of periampullary tumors: a thirty-five-year experience.

摘要: Data on 126 consecutive patients with periampullary tumors resected at the Cleveland Clinic between January 1950 and December 1984 were reviewed. One hundred five underwent pancreatoduodenal resection, 10 total pancreatectomy, 11 local resection of tumor. The site tumor was ampulla Vater (59), head pancreas (30), duodenum (20), distal common bile duct (11). Six had benign disease. operative mortality rate for radical entire period 7.8%; it has declined to 5.4% since 1974. 9.1% (one patient). overall 5-year survival all malignant area 28% 25.5% invasive adenocarcinoma. Survival affected primarily by location histologic findings. adenocarcinoma 37.2%, 27.5% duodenum, 16.7% bile, 4.3% (p = 0.0001). Papillary a 49.2% in contrast 18.4% nonpapillary ductal 0.002). Patients ampullary treated 40.9%. These data justify continued use selective approach most small high-risk patients.