title: [Diagnosis and treatment of 178 patients with carcinoma of the head of pancreas].
abstract: OBJECTIVE
  To improve the diagnosis and treatment of carcinoma of head of pancreas.
  
  
  METHODS
  A retrospective study was carried out to evaluate 178 patients suffering from carcinoma of head of pancreas.
  
  
  RESULTS
  Pain in the epigastrium and obstructive jaundice were observed in 70% and 74.2% of these 178 patients, both of which were of significance (P < 0.001) between stage I, II and stage III, IV disease. Only 18% of patients had pain in the back, 81.3% of whom belonged to the stage IV category. The detection rate of the tumor by B-ultrasound, CT and MRI were 74.2%, 87.3% and 85.5%, respectively. The success rate of pancreatoduodenectomy was 10.1%. The postoperative 1-, 3- and 5-year survival rates were 67.5%, 36% and 5.6%. Internal drainage was performed in 115 patients. The median survival time was 7 months in patients with unresectable tumor who received radiotherapy and/or chemotherapy.
  
  
  CONCLUSIONS
  Pain in the epigastrium and obstructive jaundice are the most common symptoms. Hyperglycemia is the most common complication. Pain in the back implies an advanced lesion. CT is the most important way of diagnosis and the combination of B-ultrasound, CT and MRI may improve the rate of diagnosis up to 96.6%. By now, pancreaticoduodenectomy is still the only effective treatment for the carcinoma of head of pancreas and internal drainage is an important palliative measure.
authors.affiliation: Department of General Surgical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Jianxiong
authors.initials: J
authors.lastname: Wu
authors.forename: Yongfu
authors.initials: Y
authors.lastname: Shao
authors.forename: Weiqi
authors.initials: W
authors.lastname: Rong
authors.forename: Yi
authors.initials: Y
authors.lastname: Shan
authors.forename: Jidong
authors.initials: J
authors.lastname: Gao
authors.forename: Tiecheng
authors.initials: T
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed