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[Comparative analysis of radical surgical treatment of periampullary tumors]
E Serikuly1, Sh Sh Makhanbetkhan2, Zh B Baymakhanov1
1Syzganov National Research Centre of Surgery, Almaty, Republic of Kazakhstan.
Objective:
Retrospective analysis of patients with periampullary tumors undergoing pancreatoduodenectomy.
Material And Methods:
A retrospective review included 48 patients with resectable periampullary tumors. Patients were divided into two groups according to the localization of cancer. Group 1 - pancreatic head tumors (n=27), group 2 - tumors of major duodenal papilla (n=21). Survival was analyzed depending on chemotherapy and vascular resection. All patients underwent standard pancreatoduodenectomy with anastomosis on a single intestinal loop and D2 lymph node dissection.
Results:
Annual survival rate in patients with pancreatic head tumors was significantly higher compared with patients with tumors of major duodenal papilla (69.1% vs. 95.6%, p<0.05). Moreover, vascular resection (PV/SMV) was significant predictor of survival (p<0.01). There was a noticeable tendency to impaired survival if adjuvant chemotherapy was absent.
Conclusion:
Pancreatoduodenectomy is preferred for periampullary tumors since this procedure significantly increases life expectancy. Postoperative adjuvant chemotherapy is recommended in all patients regardless histological data because combined approach is associated with improved survival.
