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Title   팽대부 주위암의 외과적 치료 ( Surgical Treatment of Periampullary Cancer )
Publicationinfo   1992 Jan; 024(02): 306-314.
Key_word   Surgical treatment, Periampullary cancer
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Abstract   This is a retrospective clinical analysis of 122 patients with periampullary cancer(including cancer of the head of the pancreas, the ampulla of Vater, the distal part of the common bile duct, and the second part of the duodenum) treated at the department of surgery, medical college of Korea University during the past 10 years. The 6th and 7th decades were the most com- mon age groups, occupying 66% of the patients, with the average age of 56.8 years. Male to fe- male ratio was 1.8: l. Approximately 50% of lesion located at the head of the pancreas. CT scan and ERCP were the principle modalities available for diagnosis, and recorded S2% and 84% of diagnostic accuracy, respectively. 65 cases(53.3%) were resected with a curative intention. Pancreatoduodenectomy was performed on 56 patients. Total and regional pancreatectomy were done on 7 and 2 patients, respectively. The resection rate for lesion of the head of the pancreas was 39%; for other periampullary tumors it was 68%. Hospital morbidity and mortali- ty following pancreatoduodenectomy were 41% and 6.9%, respectively. Among 4 patients with operative mortaliy, 2 died with complication of pancreatic leakage and 2 with bleeding TNM staging revealed 66% of the patients were in stage III, 26% in stage I, and 8% in stage IL The actuarial l, 3, and 5-year survival rates after resection were 68, 25, and 15%, respectively. In non-resected group, none survived at 18 months after treatment. We insist the only chance of survival for these unfortunate patients is a surgical resection. And relatively high portion of positive lymph node involvement(66%) may explain the poor 5-year survival in this study. In fact, among patients with stage I, the actuarial 5-year survival rate was 36%. Further investigation and effort will be neccessary to diagnose at a earlier stage and treat accordingly.
저 자   김선한(Seon Hahn Kim),김세민(Sae Min Kim)