Duodenopancreatectomy: histopathological analysis of periampullary tumors
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i4p366-373Keywords:
Pancreaticoduodenectomy, Abdominal neoplasms, AdenocarcinomaAbstract
Introduction: Cephalic Gastropancreato-duodenectomy (CGDP) is the surgery of choice for the treatment of periampullary cancers. Patients with this disease have a 5-year survival rate of 20% to 50%, being related to the resection status, stage of the disease, and tumor location. To know the biological behavior of periampullary tumors allows to plan the treatment, and the follow-up of these patients. Method: The study analyzed 105 patients through histopathological results of surgical parts of CGDP. Data regarding origin, tumor size, lymph node status, perineural invasion, angiolymphatic invasion, surgical resection margins, and differentiation of tumor were collected, and compared with the current literature. Results: Patients with malignant neoplasms were 94 (89.5%) of those who went through CGDPs. Forty percent (42) of those were pancreatic tumors, 37% (39) were duodenal papillary tumors (Vater papilla), 4% (4) had duodenal origin and 2% were distal common bile duct tumors. The mean size of the tumors was 3.43cm (p = 0.049), with 85% of the tumors larger than 2cm and 46 (52.9%) of the adenocarcinomas were stage T3. Lymph nodes were positive in 27.6% of the adenocarcinomas and the margin was R0 in 87% of the patients. Conclusion: The biological behavior of periampullary tumors is of great importance for patients who have undergone CGDP. Better treatment planning and follow-up may be offered when the histological type of these tumors is known. The experience of the centers in this surgical procedure is of important relevance in the results.
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