Diagnosis and treatment of the periampullary carcinoma in the pre-jaundice stage / 中华胰腺病杂志

ABSTRACT

Objective To explore the clinical characteristics of periampullary carcinoma in the prejaundice stage and improve early diagnosis rate and operative effects.Methods Clinical data of 27 cases with periampullary carcinoma in the prejaundice stage in our institute during the period of Jan 1998 to Dec 2005were analyzed retrospectively.Results The clinical symptom was mostly nonspecific, mainly included abdominal discomfort ( 92.6% ), abdominal pain ( 55.6% ), and irregular fever ( 29.6% ).The positive diagnosis rate with US, CT, MRCP, ERCP and EUS was 75.6%, 85.2%, 83.3%, 84.6%, and 88.9%,respectively, and they were helpful for early diagnosis.Among these 27 patients, 19 cases received regional pancreaticoduodenectomy, and 5 cases received pancreaticoduodenectomy in combination with vessel resection,3 cases received bile duct or gallbladder jejunal Roux-en-Y anastomosis, the overall resection rate was 88.9% with no operative mortality, and the post-operation complication rate was 7.4%.The 1,3, and 5 year survival rates were 100%, 70.8% and 41.7%, respectively.Conclusions The periampullary carcinoma in the prejaundice stage has its own clinical characteristics and abnormal image changes.If the diagnosis can be confirmed in the prejaundice stage, it is still an important method to improve the resection rate and prognosis.