Local resection ofampullary carcinoma at early stage

Abstract

：Objective To assess thefeasibility and indications of local resection as an alternative topancreaticoduedenectomy for the treatment of early stage ampullary cancer. Methods In thisstudy,36 patients with an AJCC.stage pTl ampullary carcinoma were operated on between 1989and 2009.Among those local resection was performed in 11 cases and pancreaticoduodenectomyin 25 cases.The main outcome measures were pre-and intra-operative diagnosis andstaing,postoperative morbidity and mortality,recurrence.free and overall survival.ResultsAmp-llary cancerat early stageWas difficult to be diagnosed and staged before and duringoperation.It was at a much lower risk to perform local resection thanpancreaticoduodenectomy.Postoperative complications were significantly lower in localresefion group than in pancreaticoduodenectomy group(P=0.031);whereas the postoperativehospital stay(P=0.254),perioperative mortality(P=1.000).disease-free survival(P=0:301)andlong-term survival(P=0.289) were not statistically different between.the two groups.Conclusions Since accurate diagnosis and staginging of early ampullary cancer wasdiit3cult to establish perioperatively.local resection should be indicated forpoor riskpafients or those who refuse pancreaticoduedenectomy.