Radical surgical treatment of malignant periampullar neoplasms

Kopchak V.M.1, Homyak I.V.1, Kopchak K.V.1, Duvalko A.V.1, Pererva L.A.1, Simonov O.M.2, Serdiuk O.M.1, Borisov B.V.1

Summary. In the article we have analyzed the results of 468 pancreaticoduodenectomies (PD) in patients with periampullary malignancies in the period of 1998–2010 years. In 344 patients standard Whipple procedure was performed, in 124 patients with malignancies of papilla of Vater or distal part of bile duct pylorus-preserving PD was preferred. We personalized our surgical strategy and implemented modern techniques of PD. In 45 patients additional vascular resections were performed. In 24 patients we implemented no-touch PD. We also analyzed the results of modified extended lymphadenectomy in patients with PD. Postoperative morbidity was 29,9%, postoperative mortality — 2,6%. Median survival was 24, 48, 72 months in patients with pancreatic cancer, bile duct cancer and cancer of papilla of Vater correspondingly. Implementation of new techniques of PD could potentially improve nearest and long-term results of PD in periampullary malignancies.
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