TUMORS OF THE PERIAMPULLARY REGION

Abstract

This study was planned to investigate the characteristics of tumors of the periampullary region, at which stage they are being diagnosed and how often they can be treated surgically. The medical records of patients who were operated for periampullary tumor in Hacettepe University Department of General Surgery between 1980-1994 were reviewed retrospectively. The number of patients was 138. The most important symptoms were abdominal or back pain, jaundice and weight loss. The sensitivity of imaging techniques was between 62.5-90%. The resectability rate was 20.3% and these resectable tumors were treated by pancreaticoduodenectomy; the rest of the patients underwent palliative procedures. Histopathologically 81.9% of the tumors were carcinoma of the head of pancreas, 10.1% were carcinoma of distal common bile duct, 7.3% were carcinoma of Ampulla Vateri and 0.7% were carcinoma of duodenum. The resectability rate for pancreatic lesions, common bile duct lesions and ampullary lesions were 14.2%, 28.6% and 80% respectively. In 28 patients who underwent pancreaticoduodenectomy, postoperative mortality rate was 7.1% and major complication rate was 35.7%. Between 1980 -1989 resectability rate was 9.6%; this rate increased to 36.3% in 1990-1994 period. One, two and five year survival rates for patients with resectable tumors were 42.9%, 21.4% and 14.3% respectively; these rates for patients with unresectable tumors were 18.2%, 7.3% and 3.1% respectively.

The majority of periampullary tumors were originating from the head of pancreas, but the resectability rate for these neoplasms was 14.2%. The resectability rate was increased by time in our institution. The survival rate significantly increases if the tumors are resectable.