Analysis of the diagnosis and treatment of 19 cases of primary duodenal malignant neoplasms / 中国普通外科杂志

ABSTRACT

Objective To improve the diagnosis and treatment of primary duodenal malignant (neoplasms)(PDMN).Methods The clinical data of 19 patients with primary malignant neoplasms of the (duodenum) were anayzed retrospectively.Results The clinical manifestations were jaudice in 9 cases, upper abdominal pain in 7 cases, gastrointestinal hemorrhage in 6 cases,abdominal mass in 3 cases,and vomitting in 1 case. Diagnostic procedure and detection rate The detection rate of PDMN by duodenoscopy was 83.3%(15/18), by hypotonic duodenography was 82.3%(14/17), 77.8%(7/9) by CT, and 1 case by MRI.16 cases (underwent) surgery with resection rate of 68.8 %(11/16).Pancreaticoduodenectomy was (performed) in 9 (cases), simple tumor resection and regional lymphadenectomy in 1 case,resection of duodenal bulb plus partial gastrectomy in 1 case,and gastroenterostomy or choledochojejunostomy in 5 cases.The radical resection rate was 62.5%(10/16).The postoperative 1-,3-,and 5-year survival rate in radical (resection) (patients) was 90.0%(9/10),40.0%(4/10) and 30.0%(3/10),respectively.In those with (gastroenterostomy) or (choledochojejunostomy), the survival time was 6~15 months. Conclusions (Duodenoscopy) and hypotonic (duodenography) are ideal tools for the diagnosis of all locations of PDMN.(Pancreaticoduodenectomy) might result in prolonged survival of patients with PDMN.