Efficacy Evaluation Of The Surgical Treatment For Malignant Tumors In Periampullary Area

Objective To compare the preoperative clinical condition,postoperative complication and long-term survival in patients underwentpancreaticoduodenectomy (PD) or palliative surgery as the treatment forperiampullary carcinomas.Method Clinical data of32cases underwent pancreaticoduodenectomyand41cases underwent palliative surgery for the treatment of periampullarycarcinomas from January2007to December2010were collected andanalyzed retrospectively.Results Data of Preoperative clinical condition from2groups werestatistically indifferent. In PD group, Postoperative complication occurred in19cases, the mobidity was59.3%, the mortality was6.2%(n=2). Thehistologic diagnosis confirmed14cases of pancreatic ductal carcinomas,2cases of ampullary carcinomas,13cases of duodenal carcinomas and3casesof cholangiocarcinomas. The average period staying in ICU was1.06±0.246days, the average staying in hospital was33.88±14.588days. Compared toPD group, postoperative complication in palliative surgery group occurred in9cases, the morbidity was22.0%. No patients died after surgery treatment. The average staying in hospital was25.20±10.342days. The histologicdiagnosis confirmed39cases of pancreatic ductal carcinomas,2cases ofduodenal carcinomas. Patients underwent palliative surgery forperiampullary carcinomas were living no more than1year. The averagesurvival time of patients underwent pancreaticoduodenectomy or palliativesurgery was15.82±0.875months and4.00±0.239months respectively（p＜0.05）.Conclusion Although the morbidity of patients afterpancreaticoduodenectomy was high compared to patients after palliativesurgery, the long-term survival was much more optimistic.Pancreaticoduodenectomy was the only effective way to treat periampullarycarcinomas when applied to the strict indication.