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We evaluated 77 patients who received pancreaticoduodenectomy among 303 pa tien ts operated for periampullary carcinoma a t Department of Surgery a t SNUH from January 1972 till December 1984 and the resu lts were as follows: 1) Among 303 cases, 163 cases(53.8%) were Pancreas head cancer, 84 cases(27.2%) were dis ta l CBD cancer, 40 cases(13.2%) were Ampulla of V ater cancer and 16 cases(5 .3%) were duodenal cancer. Resectability of Pancreas head cancer, d is ta l CBD cancer, Ampulla of V ater cancer and duodenal cancer was 11.3%; 23.8%, 82. 5%, and 37.5% respectively. 2) Diagnostic accuracy of UGIS or HTD was 30% and so the value of th a t examination was meager, 3) Overall accuracy of the diagnosis was 85.1% and among th e false negative cases, CBD stone ranked highest* 4) Incidence of Overall lymphatic m e tastasis was 24.1% and highest a t cancer of the pancreas head and lowest a t cancer of the ampulla of Vater. 5) Post-operative morbidity occurred, in 41.6% of the patients and biliary fistu la was the most frequent complication. 6) Post-operative m o rta lity occurred in 7 case s (9 .1%). 7) T he re was no relationsh ip between to ta l bilirubin level ajid post-operative complications. 8) Five year survival ra te of cancer of the Ampulla of va ter, d is ta l CBD, and pancreas head was 31.3%, 19.3% and 7.4% respectively. In view of above results, it is necessary to develops more accurate diagnostic tools for early detection and more effective post-operative adjuvant therapy in order to promote resectability and survival rate.
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