Surgical Analysis And Curative Effect Evaluation Of Duodenal Papilla Carcinoma

Background: Vater ampulla carcinoma generally refers to the origin of the pot around 2cm within the malignant tumor,which generally include: Vater ampulla,common bile duct end,pancreatic duct opening,duodenal papilla and its mucosal and other parts of the malignant tumor.For the digestive system,is not common in malignant tumors,accounting for about 5% of the digestive system of malignant tumors,the incidence of 6,7.In recent years,with the development and improvement of medical undertakings,the surgical methods of Vater ampulla carcinoma have been improved and perfected.Through retrospective analysis of 2015.05-2017.01 in our hospital,20 cases of postoperative pathology confirmed as two fingers(Including surgical mortality,early postoperative complications)in the treatment of duodenal papilla-derived Vater ampulla carcinoma.Disease,postoperative hospital stay,postoperative tumor recurrence,postoperative survival time,etc.)to assess the understanding of the duodenal papilla origin of the Vater ampulla carcinoma common surgical methods and related efficacy to the future clinical duodenum Nipple source of the Vater ampulla carcinoma diagnosis and treatment play a certain role in guiding.Objective: To summarize the common surgical methods of the periampullary carcinoma of the duodenal papilla,and to retrospectively analyze the general surgical mortality rate,the early postoperative complications,the postoperative hospital days,and the recurrence of postoperative tumor rate,postoperative survival rate and so on.Methods: A total of 20 patients with periampullary carcinoma who underwent two years from the Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed.The general information of the patients before operation and the postoperative recovery were collected.(Group A)and PD group(group B).The patients were divided into two groups: Group A and Group B.The difference of data between the two groups was analyzed by SPSS 19.0 statistical software.The postoperative curative effect of different surgical methods of the periampullary carcinoma of the duodenal papilla was analyzed,and the different postoperative curative effects were analyzed.To study the relationship between different sex,age,clinical symptoms,chronic comorbidities,preoperative laboratory indicators,operation time,postoperative pathology,postoperative hospital stay,postoperative survival rate,postoperative recurrence rate Differences in efficacy.Result: The patients were divided into local resection group(group A)and pancreaticoduodenectomy group(group B).The patients were successfully completed and no postoperative death cases were performed.The local resection group(group A)(P <0.05).There was no significant difference between the two groups(P <0.05).There was no significant difference between the two groups in age,sex and general condition.(P> 0.05),comparable.A group of patients with hypertension before surgery 1 case,B group total of 4 people there are complications,including hypertension in 3 cases,3 cases of diabetes(two patients with hypertension at the same time,diabetes).A group of preoperative complications of 16.67%,B group of preoperative complications of 28.57% of the clinical symptoms: A group of 1 case of jaundice,B group of 5 cases of jaundice,2 cases of general weakness,progressive weight loss in 4 cases,abdominal pain Discomfort 4 cases.There were 3 males and 3 females with an average age of 48.50 ± 6.18 years.There were 9 males and 5 females with an average age of 56.50 ± 6.81 years,(P <0.05).The average length of hospital stay in group A(18.33 ± 1.63)days and the average length of hospital stay in group B(24.92 ± 3.51)days.The average length of hospital stay in group A was significantly higher than that in group B(P <0.05).There were 1 case(16.67%)of complications in group A and 6 cases(P <0.05).There were 6 cases(P <0.05)42.85%),including pancreatic fistula in 3 cases,2 cases of biliary fistula,2 cases of infection,1 case of pulmonary infection.The probability of complications in group A was lower than that in group B,and the difference was statistically significant(P <0.05).There were 3 cases(50.00%)in group A and 4 cases(28.57%)in group B.The recurrence rate of group A was significantly higher than that of group B The difference was statistically significant(P <0.05).Conclusion: For duodenal papilla-derived patients with periampullary carcinoma,PD has the advantages of low recurrence rate and long-term survival rate,but with long postoperative hospital stay Postoperative complications such as high defects,if the strict control of surgical indications,PD surgery is still the source of the duodenal papilla perinatal cancer preferred treatment.2.Local resection + biliary and pancreatic duodenal resection with surgical trauma,postoperative hospital stay reduced,less postoperative complications,and its efficacy is acceptable,but from the long-term survival rate,It is not recommended as the first choice of treatment of pancreatic cancer and advanced periampullary cancer treatment,for the tumor invasion of the pancreas <2cm,the examination showed no obvious lymph node metastasis in patients can be treated as an alternative treatment one.