Abstract

ABSTRACT:
BACKGROUND:
The objective of this study is to present the results of transduodenal resection of ampullary & periampullary carcinoma and compare it with that of by-pass surgery.
METHODS:
Out of (64) patients, (35) were subjected to transduodenal resection and (29) to by-pass procedures during the period 1972-2003 at the Medical City Hospital and Al-Mustansiria Private Hospital, Baghdad.
RESULTS:
(39) Patients were males and (25) were females. Age ranged from (19-80) peak (60-69) years. Fluctuating jaundice, cholangitis and weight loss are main symptoms. Mortality was one case in both procedures. Histopathology were (29) well, (26) moderately and (9) poorly differentiated adenocarcinoma. Chemotherapy was given to (17) of the resection group and (13) patients of the by-pass group. The 2 and 5--year survival after by-pass alone was 44% and 8% compared to 68.6% and 31.4% in the resection group respectively. The size of the tumour, its grade and adjuvant chemotherapy had influence on the prognosis.
CONCLUSION:
Ampullary or periampullary carcinoma can be dealt with by transduodenal resection as a curative or palliative with results comparable to more radical procedures such as Whipple’s procedure.