A Clinical Analysis Of Local Resection In Ampullary Carcinoma

Objective To evaluate the clinical efficacy of ampullary carcinoma using local excision treatment, explore the feasibility and reasonableness of the local excision of ampullary carcinomaMethods A retrospective analysis of clinical and pathological data of 15 cases of ampullary carcinoma using local excision treatment in hepatobiliary surgery of our hospital from January 2002 to December 2013.Results Among the group of 15 patients are in the 36-38 age range(average age 55.5) 4 males( 26.7%) and 11 females( 73.3%). Among the group, seven cases because of painless jaundice treatment(46.7 %). The combined treatment of abdominal pain with jaundice are three cases(20.0%),the patient simply because of abdominal pain are three cases(20.0%), due to loss of appetite is one case(6.7%). 15 patients underwent partial resection of ampullary carcinoma, tumor diameter was 1.8 ± 1.45 cm. Pathology results : adenocarcinoma, six cases( 33.3%), moderately differentiated adenocarcinoma, 2 cases( 13.3%), poorly differentiated adenocarcinoma, 3 cases( 20.0%), tubular- villous adenocarcinoma, 1 case( 6.7%) neuroendocrine carcinoma( 6.7%), atypical hyperplasia,2 cases( 13.3%).The operation time was 133 ± 35.9min, blood loss was 161 ± 96.9ml, no cases of intraoperative blood transfusion. Hospitalization time was 22.4 ± 8.6. One patient had postoperative pyloric obstruction, 1 patient had wound infection, and 1 patient had lung infections. The remaining patients were not bile leakage, pancreatic leak, biliary tract infection, bleeding, pulmonary infection, liver failure and other complications. The group of 15 patients, 12 cases were followed, no operative mortality, 1-year, 3-year, 5-year survival rates were 83.3%, 75.0%, 58.3%.Conclusion Local excision treatment of ampullary carcinoma can be used as an important procedure, which has a small surgical trauma, quicker recovery, surgical mortality and complication rate. The key to treatment is rigorous, accurate grasp of surgery indications, skilled master surgical skills.