Carcinoma of the ampulla of Vater: long-term survival after surgical treatment.
Ninety-one patients were identified as having carcinoma arising from the ampulla of Vater. Radical pancreaticoduodenectomy, using either a standard or pylorus-preserving method, was performed in 69 consecutive patients over a 30-year period. Frequent clinical findings included jaundice (84%), a weight loss of more than 10% of the body weight (75%), abdominal pain (59%), chills and fever (52%), pruritus (48%) and a palpable gallbladder (38%). Acute pancreatitis was present in 10%. Postoperative mortality was 11.6%. Surgical mortality was 23.1% from 1962 to 1971 and 12.5% from 1972 to 1981, but was reduced to 6.3% from 1982 to 1991. Surgical mortality was primarily due to pancreaticojejunostomy leaks. The five-year survival rate was 52% and the 10-year rate was 50%. Radical pancreaticoduodenectomy for ampullary carcinoma has a low mortality and should remain the procedure of choice for ampullary carcinoma.
Wei
T C
TC
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
Yu
S C
SC
Lee
P H
PH
Hsu
S C
SC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D016019:Survival Analysis