Abstract
Twelve patients with carcinoma of the ampulla of Vater were treated from January 1977 to April 1984. The mean age of the patients (5 males and 7 females) were 58.6 years, ranging from 31 to 72 years. Postoperative complications were encountered in 41.7% of the cases, of which 25% were pulmonary complications, and 16% were breakdown of the pancreaticojejunostomy. All of the patients who developed complications were conservatively treated with no operative mortality. Twelve operative procedures resulted in 36.6% five year survivals, which is similar to the data described by Honjo.
Based on the operative findings, 50% of the patients with papillary type of cancer, and 28, 6% of the patients with ulcerating type of cancer were alive after 5 years. Seventy-five percent of the patients in stages I and II, and 14% of the patients in stage III survived at the end of 5 years. Most of the patients showed duodenal invasion of the d2 stage. Depending on the pancreatic invasion of the cancer, 100% of the patients with panc0, 25% of the patients with panc1, and 20% of the patients with panc2 were alive for more than 5 years.
All of the patients without lymphnode metastasis were alive for 5 years, only 12.50 of the patients with lymphnode metastasis were alive for 5 years. The patients with panc0 did not have lymphnode metastasis. Seventy-five percent of the patients with panci, and 83% of the patients with panc2 had lymphnode metastasis.
It is reasonable to conclude that there is a strong relationship between prognosis of patients with carcinoma of the ampulla of Vater and operative histopathological invasion of the pancreas and lymphnodes.
