| Objective:To assess the clinical features, diagnosis, treatment and prognosis of duodenal papilla tumors.Methods:Retrospective analysis of the clinical data of 76 patients diagnosed as tumor of duodenal papilla for endoscopic or surgical treatment, in the second affiliated hospital of Zhejiang University, school of medicine since April 2004 to April 2015.Results:Among the76 cases of patients, the pathological dignosis included 10 cases of benign tumors (13.2%),8 cases of precancerous lesions (10.5%),58 cases of malignant tumor (76.3%).Preoperative CT, ultrasound(US) and MRCP examinations had a high detection rate of bile duct dilation, CT had a higher detection rate of tumor than US and MRCP. Endoscopy was the best method for detection and diagnosis of duodenal papilla tumors. The coincidence rate of preoperative biopsy and postoperative pathological diagnosis was 77.6%.All the 76 patients accepted surgical treatment, among which 61 cases accepted pancreaticoduodenectomy (75%).6 cases(7.9%) performed trans-duodenum papillae resection and reconstruction, and endoscopic duodenal papilla tumor resection were performed on 5 cases (6.5%). Palliative operations were performed on only 4 cases (5.3%).Follow-up results showed that the 1,3,5 year survival rates were 74.1%,51.7% and 31.0% for patients with duodenal papillary carcinoma. The presence of lymph node metastasis was the major influence factor for survival rate.Conclusions:Duodenal papilla tumors had varied clinical manifestations, ultrasound, CT and endoscopic examination and ERCP can improve the diagnostic rate of duodenal papilla tumors. Surgical treatment was the first choice for duodenal papilla tumor. For benign tumors and early stage malignant tumors, local excision or endoscopic resection was safe and effective. For advanced malignancies, radical pancreaticoduodenectomy was essential. TNM stage, and presence of lymph node metastasis was closely related to the prognosis. |
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