We performed pancreatoduodenectomy in 153 cases of periampullary cancers among 448 surgically confirmed periampullary cancer patients during the past 15 from Jan. 1976 to Dec. 1990. Therefore only 34% of our cases were resectable.
Of these 153 cases, ampulla of Vater cancer were 61; cancers in pancreas head, 36; distal common bile duct cacer, 35; duodenal cancers, 21.
Of the 153 patients we had done percutaneous transhepatic biliary draimage in 20 patients and staged operation in 12 patients.
Operative mortality and morbidity rate were 3.9% and 41.8% respectively. Postoperative complications were 21 cases of leakage and 14 cases of hemorrhage. Wound infection was recorded in 8 cases and pulmonary complications were recorded in 19
cases.
We
analized the risk factors for complication and mortality. Among the 16 variables studied preoperative serum bilirubin level was a significant risk factor for complication(p=0.01).
By kaplan-Meire method survival analysis. the mean survival time is 51 months, with 49 months of median survival, and 1,2,3 and 5-year survival rate were 86%, 67%, 59%, and 38% respectively, Sruvival difference significantly(p=0.0001) depend upon
the
stage of each tumor.
Ar a result we think that pancreatoduodenectomy can be done with low mortality even though it has some comlications, and we can expect relatively good survival of the srugically treated periampullay cancer patients.
Early detection and resection should should be encouraged for better results.
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