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Title   팽대부 주위암의 외과적 치료 - 팽패부 주위암 환자 227 예에 대한 임상적 분석 - ( Surgical Treatment of Periampullary Cancer - A retrospective analysis of 227 patients with periampullary cancers - )
Publicationinfo   1993 Jan; 025(06): 878-888.
Key_word   Periampullary cancer, Pancreaticoduodenectomy, Survival Rate
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Abstract   In order to deduce the general characters and surgical results, authors have reviewed and analysed 22 year(1970-199l) experience of 227 cases of patienta with periampullary cancers retrospecitively, treated at the Chonju Presbyterian Hospital and Dong-A University Hospital. The results obtained were summarized ae follows. 1) There were 149 men(65.6%) and 78 women(34.4%) with mean age of 58.5 years(range 28- 78). The origin of tumors revealed that 143 cases(63.0%) occurred in the head of the pancreas, 50 cases(22.0%) in the distal common bile duct, 2l cases(9.3%) in the ampulla of Vater and 13 cases(5.7%) in the duodenum. 2) The major presenting features were abdominal pain in 174 cases(76.7%), jaundice in l46 cases(64.3%) and indigestion in 99 cases(43.6%), among which jaundice was the predominant manifestation in the resected group whereas abdominal pain in the palliated group. 3) The overall resection rate was 21.6%(49 cases)-ampulla of Vater 71.4%, duodenum 46.2%, distal common bile duct 18.0% and head of the pancreas 13.3% with operative mortality of 18.4 %(9 cases). The resectability of the cancer of the ampulla of Vater was significantly higher than those of others(F<0.005). 4) The operative mortality was significantly influenced by the age barrier over 60 years(p< 0.05), by the preoperative hyperbilirubinemia gerater than 10mg%(P<0.005), by the mode of surgical treatment of resection(P<0.005) and by the method of reconstruction other than the combined Child method & Braun anastomosis(p<0.01). 5) The overall 1-year, 3-year & 5-year determinate survival rate was 68%, 40% and 24% respectively-the ampulla of Veter 77%, 57% & 40% the distal common bile duct 71%, 40% & 25%, the duodenum 67g, 25% & 0%, and the head of the pancreas 57%, 38% 4 17%.
저 자   김상순(Sang Soon Kim),최홍조(Hong Jo Choi),이익룡(Kek Ryong Lee)