We collected and reviewed 40 patients with periampullary cancer, whose medical records were available and who received laparotomy at the Department of General Surgery of S.N.U., H. from April 1970 to August 1976.
The results were as follows:
1) 60°%0 of all periampullary cancer were of pancreas head, 27. 5% were of distal common bile duct, and 12.5% were of ampulla of Vater.
2) Male to female ratio was 2:1 and the average age was 55.3 years.
3) Frequent symptoms and physical findings were weight loss in 31 patients (77. 5%), jau-ndice in 30 patients(75%), hepatomegaly in 26 patients(65%), and abdominal pain in 24 patients (60%). There were painless jaundice in 15 patients.
4) Important laboratory findings were increased bilirubin(75%) and alkaline phosphatase (85%), and prolonged prothrombin time(57.5%). On stool gxamination, occult blood was positive in 40%, and out of 5 patients with cancer of ampulla pf Vater, 4 patients were posi-tive. Stool examination for occult blood is an important diagnostic test for cancer of ampulla of Vater.
5) There were 2 patients with pancreas head cancer who had previouslyy been diagnosed as diabetes, and 2 patients who had increased fasting blood sugar and glycosuria on urinalysis.
6) Pancreatico-duodenectomies were performed on 14 patients(35%), palliative operations on 21 patients(52.5%), and biopsy only on 5 patients(12.5%).
7) Postoperative complications occurred on 4 patients who; received pancreatico duodenectomy and 4 patients who received palliative operations. There was one death among the 14 pancre-atico-duodenctomy cases giving a mortality rate of 7.1%, and four deaths among the 21 pallia-tion cases giving a mortality rate of 19%.
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