[Duodenal malignancies--differential diagnosis and therapeutic aspects]

Primary malignant duodenal tumors are rare, their prognosis dismal. From 1978 to 1984 only 7 patients with true duodenal malignancies were operated at the Department of Surgery, Heidelberg. Primary symptoms of the disease are the following: gastric outlet obstruction in stenotic growth (n = 5), occlusion of extrahepatic bile ducts in peripapillary growth (n = 3) and ulcer signs in ulcerous-penetrating growth. Endoscopy of the duodenum with guided biopsy proved to be the most important diagnostic procedure. In primarily resectable tumors partial pancreatiocoduodenectomy represents the best procedure for cure in our experience.