[Diagnosis and surgical treatment of primary duodenal carcinoma].
OBJECTIVE
To investigate the early diagnosis of primary duodenal carcinoma and its outcome after surgical procedure.


METHODS
Twenty-two patients with primary duodenal carcinoma treated operatively between 1983 and 1997 were analyzed retrospectively. Eleven patients complained of epigastric pain and discomfort, 5 jaundice, 4 nausea and vomiting and 2 epigastric fullness. The correct diagnosis rate for endoscopy was 90.0% (9/10), for duodenography 86.7% (13/15), for ultrasound examination 33.3% (4/12) and for computerized tomography (CT) scanning 58.3% (7/12), respectively. All of the 22 patients received surgery including pancreaticoduodenectomy (12 patients), segmental resection (4) and bypass operation (gastrojejunostomy and cholecystojejunostomy or cholangiojejunostomy) (6).


RESULTS
Primary duodenal carcinoma was characterized nonspecifically, and the correct diagnosis was based on endoscopy and duodenography. The follow-up rate of this group was 86.4% (19/22). The 1-, 3-, 5-year survival rates of patients receiving radical resection (n = 16, 1 patient lost follow-up) were 86.7% (13/15), 46.7% (7/15), and 26.7% (4/15), respectively. The 5-year survival rate of patients receiving pancreaticoduodenectomy was 27.3% (3/11), and the 5-year survival rate of patients having segmental resection was 1/4. No patient (n = 6, 2 lost follow-up) with primary duodenal carcinoma treated by bypass procedure survived more than one year. There was a significant difference between patients receiving radical procedure and bypass operation (chi(2) = 6.84, P < 0.01).


CONCLUSIONS
Radical resection might improve the survival of patients with primary duodenal carcinoma.
Wang
Jing
J
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medicine Sciences, Beijing 100021, China.
Gao
Ji-dong
JD
Shao
Yong-fu
YF
D000328:Adult; D000368:Aged; D004379:Duodenal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate