Clinical analysis on 130 cases of primary tumor of the duodenum / 中华普通外科杂志

ABSTRACT

ObjectiveTo investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum.MethodsThe clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. ResultsMore than 90％ of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59％ of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100％. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84％.The 5-year survival rate was 46％ in 59 cases receiving Whipple's procedure.ConclusionsPrimary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.