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KMID : 0377619620030060573
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Korean Jungang Medical Journal
1962 Volume.3 No. 6 p.573 ~ p.585
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Pancreatoduodenectomy
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ÑÑâª÷Á/Kim, Soo Tae
õËÑÎâª/ÚÓóàý÷/ì°ÌÔéô/ÑÑðóÏÐ/ì°ü¤çµ/üÜñÕãÕ/Choi, Kil Soo/Park, Tchang Hee/Lee, Kyung Wook/Km, Jong Kook/Lee, Hwa Young/Whang,Jun Shik
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Abstract
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It is the purpose of, the present article to report our experience of six cases of pancreatoduodenectomy and one case of total pancreatectomy performed for a period of one year from August 1961 to August" 1962, and clinical Symptoms and findings, histologicexaminations complications and mortality and survival rates were decribed and discussed.
The results are as follows.
1. All patients were males. The youngest patient was 32 years of age and the oldest 62 years of age. The average years of age were 42 years.
2. Duration between the onset and admission was one and half to six months except four year¢¥s history of the illness in a case of adenoma of the pancreatic head
3. The clinical symptoms and findings, as shown inTable 1, consisted of indigestion in seven patients (100%), weight loss in six (85.7%), each on of abdominal pain, jaundice and enlarged gallbladder in five patients (71.4%). Roentgenologic examination before operation revealed displacement of the stomach and invasion of the duodenum or widening of the duodenal loop in five patients(71.4%)
4. As shown in Table-2 histologic examination revealed one case each of adenocarcinoma, adenoma and carcinoma (by clinical diagnosis with out microscopic examination) of the pancreatic head; 2 cases of the ampulla of Vater; one case of adenecarcinoma of pyloric region of the stomach.
5. One stage radical operation was performed on five patients(71.4%), and two stage radical peration on two patients(28.6%).
6. Complications were shown in Tables 3 and 4. Diabetic coma developed following total pancreatectomy. Two patients had no complication. A case of carcinoma of the pyloric region of the somach was complicated by obstructive jaundice after the first one stage operation, and there fore the second operation was done, but biliary and pancreatic fistulas occurred thereafter. A case carcinoma of the common bile duct was complicated by biliary fistula and wound infection following two stage operation . Atelectasis developed in a case of sdenoma of the pancreatic headd after two stage opeation , and there was another case with the complication of obstructive jaundice. Eighty per cent in the jaundiced patient and fifty per cent in the not - jaunciced patient had complications.
7. the patient subjected to total pancreatectomy died 5 days agter the operation.
8. the patient with pyloric cancer survived for 5 mnths after the operation. One patient with post-operative jaundice left the hospital on the fifth postcperative day, and one patient remained in the hospital for 60 days with postoperative wound infection. But the other patients were discharged with gavorable recovory 30 to 60 days after the operation .
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