팽대부 주위암의 외과적 치료 - 팽대부 주위암 환자 227예에 대한 임상적 분석-
Surgical treatment of Periampullary Cancer -A Retrospecitve analysis 227 patients with periampullary cancers-
대한암학회지 1993년 25권 6호 p.878 ~ 887
김상순, 최홍조, 이익룡,
소속 상세정보
김상순 ( )
동아대학교
최홍조 ( )
동아대학교
이익룡 ( )
동아대학교
KMID : 0360319930250060878
Abstract
In order to deduce the general charaters and surgical results, authors have reviewed and analysed 22 year(1970~1991) experience of 227 cases of patients with periampullary cancers retrospecitively, treated at the Chonju Presbyterian Hospital and
Dong-A
University Hospital.
@ES The results obtained were summarized as follows.
@EN 1) There were 149 men(65.6%) and 78 women(34.4%) with mean age of 58.5% years(range 28~78). The origin of tumors revealed that 143 cases(63.0%) occurred in the head of the pancreas, 50 cases(22.0%) in the distal common bile duct, 21
cases(9.3%)
in
the ampulla of Vater and 13 cases(5.7%) in the duodenum.
2) The major presenting features were abdominal pain in 174 cases(76.6%), jaundice in 146 cases(64.3%) and indigestion in 99 cases(43.6%), among which jaundice was the predominant manifestation in the resected group whereas abdominal pain in the
palliated group.
3) The overall resection rate was 21.6%(49 cases)-ampulla of Vater 71.4%, duodenum 46.2%, distal common bile duct 18.0% and head of the pancreas 13.3%-with operative mortality of 18.4%(9 cases). The resectability of the cancer of the ampulla of
Vater
was significantly higher than those of others(P<0.005).
4) The operative mortality was significantly influenced by the age barrier over 60 years(P<0.05), by the preoperative hyperbilirubinemia gerater than 10 mg%(P<0.005), by the mode of surgical treatment of resection(P<0.05) and by the method of
reconstruction other than the combined Child method & Braun anastomosis(P<0.01).
5) The overall 1-year, 3-year & 5-year determinate survival rate was 68%, 40% and 24% respectively-the ampulla of Vater 77%, 57% & 40%, the distal common bile duct 71%, 40% & 25%, the duodenum 67%, 25% & 0%, and the head of the pancreas 57%, 38%
&
17%.
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