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十二指腸 膨大部 周圍癌

Peri-Ampullary Carcinomas

대한외과학회지 1963년 5권 6호 p.367 ~ 372
허경발, 장영상, Okane, Naoko,
소속 상세정보
허경발 (  ) - 연세대학교 의과대학 외과학교실
장영상 (  ) - Children´s Hospital City of Seoul
 ( Okane, Naoko ) - Yonsei University College of Medicine Yung Dung Po City Hospital and Surgery

Abstract


Thirteen cases of pari-ampullary carcinomas were seen and treated by surgery at Yonsei University College of Medicine from Jan. Ist 1959 to June 1962.
Clinical records of 9 male and 4 female patients were analysed. Average age of these 13 patients is 55.6 years, the youngest is 39 and the oldest is 70 years of age. 8 patients had carcinoma in head region of pancreas, 3 patients had carcinoma in Ampulla of Vater and 2 patients harboured carcinoma in distal common bile duct. Average duration of disease for carcinomas in head of pancreas, in Ampulla of Vater and in common bile duct is 5.6, 2 and 3 months respectively.
Jaundice was the most frequent complaint, and offered by 11 patients. Weightloss was noticed in 9 patients. Significant physical findings are: yellowish discoloration in skin and sclera in 11 cases, direct tenderness in right upper quadrant area in 10 cases and palpable gall-bladder was confirmed pre-operatively in 4 cases.
Radical Pancreatico-duodenectomy was performed in 3 patients. All kind of By-pass procedures were applied in 7 cases and gall-bladder was utilized 5 times for the By-pass procedures.. In three cases of radical pancreatico-duodenectomy single loop of jejunum was utilized for reconstruction of gastro-intestinal continuity. End-to-side pancreatico-jejunostomy was done in one patient and end-to-end pancreatico-jejunostomy was performed in the other 2 patients. Common bile duct and stomach were anastomesed to the side of distal jejunum respectively in all cases.
Survival time after each operative procedure is as follows: After radical procedures average survival is 14.5 months and one of them is still alive. Average survival after By-pass procedures is 7.4 months but survival in three patients in whom neither radical pancreatico-duodenectomy nor By-pass procedure was performed is 3.9 months. One hospital death was not included to average survival time after radical pancreatico-duodenectomy.

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