Journal Name:
- International Journal of Medical Research & Health Sciences
Abstract (2. Language):
Objectives: Periampullary carcinoma is a term widely used to define a heterogenous group of
neoplasms arising from the head of the pancreas, ampulla of Vater, terminal common bile duct and the
duodenum. Periampullary carcinomas typically have either the intestinal type or pancreatobiliary type of
the differentiation. The prognostic importance of the type of differentiation is studied in relation to the
other prognostic factors like resection margin involvement, tumour size, nodal involvement, vascular
infiltration, perineural growth and degree of differentiation. Methods: 50 whipples resected specimens
were analyzed. In these cases 33 were periampullary carcinomas and the remaining were chronic
pancreatitis. The clinical features, laboratory investigations and histopathological features of
periampullary carcinomas were studied. Prognostic factors were studied in two histological types of
periampullary carcinomas i.e. intestinal type and pancreatobiliary type. Results: Out of 33
periampullary carcinomas 24 were intestinal type and 9 were pancreatobiliary type. Periampullary
carcinomas were common in females (54.5%) and were seen mostly in the age above 60yrs (36.4%).
Jaundice was the most common presenting symptom. Independent adverse prognostic factors seen in the
pancreatobiliary type of differentiation were tumor size more than 2.5cm (66.7%), tumor stage, regional
lymphnode involvement (77.8 %), vessel involvement (55.6%), perineural growth, areas with poor
differentiation (66.7%) and serum CA19-9 levels more than 200U/ml (77.8%). Conclusion: In
periampullary carcinomas histological type of differentiation is very important independent prognostic
factor. In the two histological types of carcinomas pancreatobiliary has worse prognosis when compared
to intestinal type.
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FULL TEXT (PDF):
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380-387