Carcinoma of the ampulla of vater and duodenum

ABSTRACT

The present study was carried out on 13 patients with carcinoma of the ampulla of vater and duodenum. Fiberopic duodenoscopy was the most helpful preoperative diagnostic measure. Preoperative frozen section biopsy was diagnostic in 69.2%. Most of the tumors were of the non papillary type [9 cases]. Only 3 patients were fit for curable radical excision [pancreaticoduodenectomy]. Local transduodenal resections were associated with no operative mortality but a high recurrence rate 71%. The overall operative mortality was 7.69% with a mean survival of 21 months. Patients with papillary adenocarcinoma had a longer postoperative survival period. Patients with resectable tumors of the less invasive papillary carcinoma were recommended for pancreaticoduodenectomy. Non papillary carcinoma would preferably be treated by transduodenal local excision. Advanced irresectable tumors are better managed by endoscopic biliary decompression