ABSTRACT
An experience with treatment of 62 patients with carcinoma of the major duodenal papilla during the period of 1989-1999 is generalized. Mean age of the patients was 62.4. Most of the patients admitted (85%) had jaundice. The most informative method of examination was FGDS, its sensitivity was 84%. All the patients were operated on. Transduodenal papillectomies (TDPE) were performed in 10 patients, pancreatoduodenal resection (PDR) in different modifications--in 42 patients, in 2 of them for recurrent carcinoma after TDPE, biliodigestive anastomoses--in 13 patients. Resectability was 80%, postoperative lethality--0%. Postoperative complications after PDR developed in 21% of the patients. Recurrent tumors after TDPE appeared in half of the patients. The actuarial five year survival after PDR was 50.6%. PDR is considered to be the operation of choice for cancer of the major duodenal papilla.
Subject(s)
Ampulla of Vater , Carcinoma/diagnosis , Carcinoma/surgery , Common Bile Duct Neoplasms/diagnosis , Common Bile Duct Neoplasms/surgery , Adult , Aged , Ampulla of Vater/pathology , Ampulla of Vater/surgery , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/surgery , Pancreaticoduodenectomy/methods , Sphincterotomy, Endoscopic , Treatment OutcomeSubject(s)
Esophageal Diseases , Adult , Esophageal Diseases/diagnosis , Esophageal Diseases/surgery , Follow-Up Studies , Humans , Male , Rupture, Spontaneous , Time FactorsABSTRACT
An experience with treatment of 30 patients with ruptures of the esophagus of different genesis is generalized. The differentiated approach to choice of the method of treatment and character of surgical procedures, wider indications to plastic interventions on the esophagus wound with its suturing layer-after-layer, wide disclosure of the mediastinum and its purposeful drainage, use of the modern detoxication means favoured the achievement of quite satisfactory results of treatment. Lethality was 6.7%.
