Comparison Curative Operation with Internal Drainage Procedure of Periampullary Ca

Choi, Seong Young; Kim, Jae Hong; Park, Ju Sup

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.