저위험군 팽대부암에서의 경십이지장 국소 절제술
Transduodunal Local Resection for Low Risk Group Ampulla of Vater Cancer Patients
박준성, 윤동섭, 박영년, 이우정, 지훈상, 김병로,
소속 상세정보
박준성 ( Park Joon-Seong )
국군수도통합병원 외과
윤동섭 ( Yoon Dong-Sup )
연세대학교 의과대학 외과학교실
박영년 ( Park Young-Nyun )
연세대학교 의과대학 병리학교실
이우정 ( Lee Woo-Jung )
연세대학교 의과대학 외과학교실
지훈상 ( Chi Hoon-Sang )
연세대학교 의과대학 외과학교실
김병로 ( Kim Byong-Ro )
연세대학교 의과대학 외과학교실
KMID : 0371320040660050404
Abstract
Purpose: A carcinoma of the ampulla of Vater has more favorable prognosis than other malignant tumors of the periampullary region, because it is symptomatic at an early stage. However, local resection of an ampullary carcinoma remains controversial. The aim of this study was to evaluate the treatment results of ampulla of Vater carcinomas, according to operation type in low risk group patients.
Methods: The records of 17 low risk group patients, among 120 patients with ampulla of Vater cancer, who underwent curative surgery beyween 1992 and 2002, were reviewed. All specimens were critically reviewed by a single expert pathologist. The relationship between surgical outcomes and operation type were assessed.
Results: There were 10 men and 7 women, with a median age of 57.8 years. 13 of the 17 patients underwent the Whipples operation or a PPPD, and 4 underwent a transduodena1 local resection (TDLR). The operation time was shorter in the TDLR group, and was statistically significant. Among the 17 patients, only one had a recurrence in the inguina area 33 months after the PD.
Conclusion: Transduodenal local resection is a recommendable operation for low risk Ampulla of Vater cancer patients. During the operation, it is essential to accurately evaluate the depth of invasion, cell differentiation and positivity of the resecticln margin using frozen sections.
키워드
팽대부 악성 종양;저위험군;국소 절제술;Ampulla of vater cancer;Low risk group;Local resection
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