Management of Patients with Ampullary and Periampullary Tumors in Gastro-Entrology and Hepatology Teaching Hospital
Iraqi Postgraduate Medical Journal,
2015, Volume 14, Issue 4, Pages 454-461
Ampullary and periampullary tumors are composed of a group of malignant and benign neoplasms arising in the region of the ampulla of Vater and are a major problem to the patients and surgeons and their management remains a big challenge.
Study the age, sex distribution, presentation and management of patients with ampullary and periampullary tumors in Iraq and compare it with other world reports
PATIENTS AND METHODS:
prospective study of 50 patients with ampullary and periampullary tumors carried out in GIT hospital (tertiary center) from January 2013 to March 2015 ,risk factors ,age ,sex ,clinical presentation ,images study ,diagnosis and modality of treatments whether curative or palliative are studied.
29 (58%) were males and 21 (42%) were females , about the age distribution the mean age was 45 ,about the residency they were mainly from Baghdad in (40%) ,the presenting symptom was obstructive jaundice in 43 (86%) ,duration of illness (range from 1-2 months) with the mean period 45 days , abdominal ultrasound study reveal distended Gallbladders in 76 % , dilated CBD in 82% ,dilated pancreatic duct in 56% , Hepatomegaly in 42% , dilated intrahepatic billiary tree in 64% , and liver secondary in 10% .resection surgery was done in 50% ,palliative surgery in 12% and endoscopic palliation in 38%
Ampullary and periampullary tumors are relatively common. The mean age is 45 years, lower than the western studies. Sex: male are affected 1.4 times more than female with male: female ratio = 1.38 . Abdominal ultrasound is very informative but EUS,CT scan and MRI, MRCP is the cornerstone for the diagnosis, Normal looking papilla does not rule out occult ampullary tumor.
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