Periampullary Cancer – Our Institutional Experience with Review of Literature

Abstract

1 Assistant Professor of Surgery, Andhra Medical College, Visakhapatnam, India 2, 4,5 Junior Resident of Surgery, Andhra Medical College, Visakhapatnam, India 3 Associate Professor of Surgery, Andhra Medical College, Visakhapatnam, India *Corresponding Author Dr Anantha Ramani Pratha Associate Professor of Surgery, Andhra Medical College, Visakhapatnam, India Abstract Introduction: Pancreatic and periampullary carcinomas include a group of malignant neoplasms arising in or near the ampulla of Vater or in the pancreas. Diagnosis, management and prognosis have improved considerably in the last few decades. The present study looks into the modes of presentation in patients with periampullary carcinoma, the different modalities of investigations, treatment along with the postoperative complications. Materials and Methods: It is a retrospective, descriptive study including 25 patients of periampullary carcinoma studied over a period of one and half year from January 2017 to June 2018 in a tertiary care centre in Visakhapatnam. In the present study, age and sex distribution, site of tumour origin, histopathological variant, postoperative complications and other factors were evaluated. We have adopted the classical Whipple’s Pancreaticoduodenectomy as the procedure for the treatment of operable periampullary cancers. Results: The mean age of presentation was 52.6 years. The male to female ratio was 2.5:1. The most common site of tumour origin was the head of pancreas. Majority were well differentiated adenocarcinomas. The most common postoperative complications were pancreatic leak and wound infection (14.2%). Conclusion: Patients with pancreatic and periampullary cancer represent a difficult and challenging group to treat. Pancreaticoduodenectomy is a standard procedure that has been adopted for the treatment of this group of cancers. Resection should be performed by experienced surgeons to minimize morbidity and mortality. Though these patients have a poor prognosis, with proper staging, good patient selection and appropriate management, there is improved survival and wellbeing of these patients.