Radical Resection For Periampullary Carcinomas

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Abstract
• Radical pancreaticoduodenectomy for periampullary cancer was performed in 53 patients over a 22-year period. All tumors were adenocarcinomas: 35 patients had adenocarcinoma involving the head of the pancreas, nine, the Vater ampulla, seven, the distal common bile duct, and two, the duodenum. There were nine hospital deaths (17%). The postoperative course was classified as uneventful in 33 patients (62%). Thirty of the 39 patients who left the hospital died later, with evidence of recurrent carcinoma. The actuarial survival rate for the 53 patients was 51% ± 6.9% at one year, 12% ± 4.6% at five years, and 7% ± 3.9% at ten years. Patients surviving 3.5 or more years appeared to have a decrease in their cancer mortality. We discuss actuarial survival rates, according to the location of the tumor. This experience suggests that radical pancreaticoduodenectomy is indicated to remove small, localized periampullary carcinomas in patients who are otherwise in good health. (Arch Surg112:245-249, 1977)