Experience for Management of Surgical Treatment in Patients with Carcinomas of the Pancreatic Head or Periampullary Region

Abstract

Objective: Pancreaticoduodenectomy was considered as the standard choice of surgery treatment to carcinomas in the pancreatic head or periampullary region. This study will focus on the experience summary to manage the patients with carcinomas in the pancreatic head or periampullary region who underwent surgery treatment in west area of China to investigate the different surgical methods, prognosis and long term survival. Method: We consecutively reviewed 73 patients underwent surgery treatment in our hospital between January 2007 and December 2011. Surgery treatment described as radical operation of PD treatment and palliative operation of choledochojejunostomy plus drainage. We assessed different variables to summarize the management of patients and to evaluate the long term survival. Result: 32 patients received PD treatment and 41 patients received palliative surgery treatment. Histologic diagnosis indicated that all patients had malignant disease. PD procedures spent more time to complete the operation. 3 patients in PD group developed pancreatic fistula and 1 of them died on the seventh days postoperative. 2 patients developed wound infection and 1 patient developed malnutrition which finally reversed by medical intervention. The postoperative mortality in PD group was observed in 2 of 32 patients. The postoperative mortality in PD group was 6.25% (n=2). Long term survival of PD and palliative surgery group was described as 15.4 months and 5.6 months respectively. Conclusion：The treatment of patients with carcinomas in the pancreatic head or periampullary region continues to be associated with high incidence of postoperative complicatons. Early diagnosis and pancreaticoduodenectomy represents the only possibility of cure.