Comparison Curative Operation with Internal Drainage Procedure of Periampullary Ca

ABSTRACT

BACKGROUND: The optimal management of periampullary Ca. stage III remains controversial. METHODS: A total of 103 patients treated in a 5-ear period at Kwangju Christian Hospital, 54 patients with a curative operation and 49 patients with internal drainage, were retrospectively studied. RESULTS: There was no significant difference in the 30-ay mortality rate between patients with a curative operation and those with internal drainage, 4% versus 6% respectively. There was a difference between a curative operation and the internal drainage procedure in the early morbidity rate (16.7% versus 8%) and the late morbidity rate (9.3% versus 32.7%). The mean survival was more favorable for those with a curative operation than for those with the internal drainage procedure for periampullary Ca. stage III (pancreatic Ca. 11.6 months versus 4.7 months, CBD Ca. 12.6 month versus 5.4 months, and Ampulla of Vater Ca. 16.5 months versus 5.6 months). The 6-onth and the 12-onth survival rates of the curative-operation group were 80% and 55% for pancreatic Ca., 100% and 80% for CBD Ca., and 90% and 80% for Ampulla of Vater Ca.. The 3-onth and the 6-onth survival rates of the internal drainage group were 70% and 30% for pancreatic Ca., 85% and 40% for CBD Ca., and 75% and 45% for Ampulla of Vater Ca. CONCLUSION: The mean survival duration was more favorable for those with a curative operation than for those with an internal drainage procedure for periampullary Ca. stage III. Therefore, if there is no evidence of distant metastasis, a radial resection is the treatment of choice for a patient with a carcinoma of the periampullary Ca.