[Broad indications for cephalic duodenopancreatoctomy].
Carcinoma pancreas takes fourth place based on the representation of carcinoma digestive methodology. Morbidity is about 16% of total morbidity carcinoma digestive system. Early discovery is relatively tough and resection in comparison to discovered cases amounts only 2-5% cases, and in the last period it increased from 10-15%. According to the data of different authors, localization of tumor in the head of pancreas is between 70% and 84% cases. Two times is more often on the male individuals. When we are talking about contraindications of cephalic duodenopankreatectomy in each case absolute contraindication is considered present of liver metastasis and carcinoma peritoneuma. Most of the authors, mainly, present general contraindications such as: resection of lazier, ascit and general condition of patient. Contraindication for the operation is extended ikterus with albminima below 30 g/l. This type of exam shows serious damage of the function of liver. Elison and sur in 1984 noticed that preoperative bilijarna decompresy can decrease postoperative mortality up to 30%, which refers to all operations as well as palliative and radical. Older patients (above 70 years) with pre-comatose or comatose conditions and the patients with the size of the tumor of head pancreas above 1.5 cm, as well as patients with infiltration of veins mesenteric or ports are considered inoperative since resection of large blood veins as well as total pankreatektomia is not prolonging life of patient. Mortality on the cephalic duodenopankreatectomy is oscillating and in the literature data it is found from 10%, and above 30% and in high specialized institutions about 5% or even 0%. According to the statement of the clinic Mayo in 89 cases surviving above five years has been less then 5% and average survival was 1.03 years. Hower is mentioning that five year survival in USD amounts about three pro mile. In our subject we have analyzed operated cases in one year. For the whole year it was operated 14 patients. Considering the number of citizens which are treated at KCUS, it is higher number from the statistics found in the literature. Only one patient had bilirubin, which was within normal limits, while all other patients were operated with increased value of bilirubin. Albumins below 30 g/l were present on the four patients. Ten patients had the size of tumor above 2 cm. One patient after post operation died which amounts to 7, 14% cases and coincides with the facts from the literature. In the conclusion indication for the radical operative treatment of tumor of head pancreas are expanding and operative mortality is decreasing.
Tanović
Haris
H
Klinika za Abdominalnu Hirurgiju, Klinicki Centar Univerziteta u Sarajevu.
Juricić
Ratko
R
Aksamija
Goran
G
Sabanović
Jusuf
J
Muhović
Samir
S
Mulabdić
Adi
A
D000368:Aged; D014670:Ampulla of Vater; D002277:Carcinoma / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy