期刊论文详细信息
BMC Surgery
Transduodenal ampullectomy provides a less invasive technique to cure early ampullary cancer
Research Article
Hongcheng Wang1  Xiuyan Huang1  Xinyu Huang1  Yang Gao1  Yayun Zhu1  Zhou Yuan1 
[1] Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, 200233, Shanghai, China;
关键词: Transduodenal ampullectomy;    Pancreatoduodenectomy;    Lymph node metastasis;    Early ampullary cancer;    Free resection margin;   
DOI  :  10.1186/s12893-016-0156-z
 received in 2016-01-12, accepted in 2016-05-26,  发布年份 2016
来源: Springer
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【 摘 要 】

BackgroundThe aim of this study was to evaluate the clinical efficiency of transduodenal ampullectomy (TDA) compared to conventional pancreatoduodenectomy (PD) in patients with early ampullary cancers.MethodsWe carried out a retrospective study by reviewing the medical records of 43 patients with early ampullary cancer who underwent either TDA or PD from January 2001 to December 2014. TDA and PD were performed on 22 patients and 21 patients, respectively. Clinical data, perioperative clinical outcomes and prognosis were evaluated. The median follow-up was 75 (range, 38–143) months.ResultsThe sensitivity of intraoperative frozen resection was 100 % (4/4) and 94.9 % (37/39) in patients with pTis and pT1 tumors compared to final histologic diagnoses. The 5-year survival rate of patients with early ampullary cancer was 77.3 % in TDA group and 75.9 % in PD group (P = 0.927). Patients with lymph node metastasis presented a shorter 5-year survival rate (P = 0.014). TDA was associated with lower surgical morbidity (P = 0.033), estimated blood loss (P = 0.002), medical cost (P = 0.028) compared to PD. No pancreatic fistula and surgical mortality occurred in TDA group.ConclusionsTDA could produce satisfactory clinical efficiency in patients fulfilled the following criteria simultaneously: pTis or pT1 stage, tumor size ≤ 2 cm, without lymph node metastasis. To achieve favorable outcomes, intraoperative frozen section examinations should be reliable and resection margins should be negative.

【 授权许可】

CC BY   
© The Author(s). 2016

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