Document Detail

Evaluation of resection of the papilla of Vater for the treatment of cancer in the papilla of Vater.
MedLine Citation:
PMID:  12971258     Owner:  NLM     Status:  MEDLINE    
We evaluated the resection of the papilla of Vater performed in patients with cancer in the papilla of Vater. The subjects were 6 patients who underwent resection of the papilla of Vater between January 1969 and December 2001. The patients aged 57-87 years consisted of 3 males and 3 females. The maximal diameter of the tumors was 0.5 cm in 1 patient, 1.5 cm in 3 patients, and 2.0 cm in 2 patients. Macroscopically, the tumors were of the protruded type (exposed) in 3 patients, of the mixed type (predominant protruded type) in 2 patients, and of the ulcerative type in 1 patient. The histological depth of the tumors was up to the mucosa in 1 patient, up to the oddi in 1 patient, up to the panc0, du1 in 1 patient, up to the panc1, du2 in 1 patient, and unknown in 2 patients. Histologically, the tumors were papillotubular adenocarcinoma (pap-tub) in 4 patients and tubular adenocarcinoma of the well-differentiated type (tub1) in 2 patients. Resection of the papilla of Vater was chosen because of high risk factors such as advanced age in 2 patients, complicated severe cirrhosis and confinement to bed due to poor systemic conditions after intracerebral hemorrhage in 3 patients, and hepatic metastasis observed during surgery in 1 patient. Residual cancer cells around the excised region were positive in 4 patients and unknown in the remaining 2 patients. Of the 6 patients, 5 died within 2 years after surgery, but 1 is alive without symptoms of recurrence 7 years after surgery. The death causes were the primary disease in 3 of the 5 patients. From the viewpoint of radical treatment, resection of the papilla of Vater cannot be chosen as a reduced surgery for cancer in the papilla of Vater. However, resection of the papilla of Vater can be applied to very elderly patients and patients under poor systemic conditions, for whom pancreatoduodenectomy (PD) is considered excessively invasive due to a small diameter of tumor.
Hisafumi Kinoshita; Masao Hara; Kazunori Nishimura; Takahito Kodama; Hideki Matsuo; Ryuichi Kawahara; Masafumi Yasunaga; Hisamune Sakai; Masaharu Odo; Koji Okuda; Kazuo Shirouzu; Shigeaki Aoyagi
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Kurume medical journal     Volume:  50     ISSN:  0023-5679     ISO Abbreviation:  Kurume Med J     Publication Date:  2003  
Date Detail:
Created Date:  2003-09-15     Completed Date:  2003-10-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985210R     Medline TA:  Kurume Med J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  17-9     Citation Subset:  IM    
Department of Surgery, Kurume University School of Medicine, Kurume 830-0011, Japan.
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MeSH Terms
Aged, 80 and over
Ampulla of Vater / pathology,  surgery*
Middle Aged
Pancreatic Neoplasms / surgery*

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