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Radical Resection for Carcinoma of the Ampulla of Vater

John R. T. Monson, MD, FRCSI, FRCS; John H. Donohue, MD; Gerard P. McEntee, MD, FRCSI; Donald C. Mcllrath, MD; Jon A. van Heerden, MB, FRCSC; Roy G. Shorter, MD, FRCP; David M. Nagorney, MD; Duane M. Ilstrup, MS
Arch Surg. 1991;126(3):353-357. doi:10.1001/archsurg.1991.01410270099016.
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• One hundred four consecutive patients who underwent radical resection for ampullary cancer between 1965 and 1989 were retrospectively reviewed. Frequent clinical findings included jaundice (67%), significant (>10%) weight loss (42%), and anemia (27%). Eighty-seven patients (84%) underwent a subtotal pancreatectomy, and 17 patients (16%) underwent a total pancreatectomy. The postoperative mortality was 5.7% (six patients), and reoperation for postoperative complications was required in six patients. The 5-and 10-year survival rates were 34% and 25%, respectively. Eight patients died of tumor recurrence more than 5 years after resection. Patient survival was significantly impaired by microscopic lymphatic invasion, regional nodal metastasis, tumor grade, and the epithelium of origin. In a multivariate analysis, only microscopic lymphatic invasion significantly reduced patient survival. Radical resection for ampullary cancer can be performed with a low morbidity and mortality and should remain the procedure of choice for ampullary carcinoma.

(Arch Surg. 1991;126:353-357)


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