The diagnosis and treatment of 86 cases of primary duodenal tumors / 中国普通外科杂志

ABSTRACT

Objective To investigate the diagnosis and therapeutic methods of primary tumors of duodenum(PTD).Methods Clinical data of 86 patients with primary duodenal tumors who were hospitalized in the First Affiliated Hospital of China Medical University during 26 years were analyzed retrospectively.Of all the tumors,18 cases were benign tumors and 68 cases were malignant tumors.Results The clinical(manifestations) were symptoms of bile duct obstruction,GI and nonspecific symptoms,and signs included(fever),anemia and weight loss.The correct preoperative diagnostic rate by auxiliary examinations were(duodenal) endoscopy 92%,air barium double radiography 89%,MRCP 85%,BUS 33%,CT 51%,MRI 75%,and duodenal endoscopy combined with air barium double radiography were 95%.Tumors were mostly located in the descending portion of duodenum(71 cases).Eighteen cases of benign PTDs were resected(completely) with a 5-year survival of 92.3%.Among the 68 maligant PTD cases,35 cases underwent(pancreatoduodenectomy),and 8 cases received segmental duodenectomy,with a resection rate of 63.2% and the 5-year survival rate of 31.0%.The remaining 25 cases,in which the tumors were unresectable,were treated by bypass operations,the 5-year survival rate was 0%.Conclusions Patients with PTD usually lack specific symptoms and signs,but combination of endoscopy,GI air barium double radiography and other(examinations) can improve the preoperative positive diagnostic rate.Segmental duodenectomy and simple tumor resection are curable for primary benign tumors of duodenum;while for primary malignant tumors of(duodenum),the therapy of choice should be pancreatoduodenectomy.