<総説>原発性十二指腸乳頭上部癌および乳頭下部癌 : 本邦報告例について

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Two hundred and sixty-four cases of primary duodenal carcinoma excluding carcinoma of the papilla of Vater reported in the Japanese literature including our own case since 1970 were reviewed. Overall male-to-female ratio was 1.3 : 1,the average age of males was 59.1 years and of females was 59.8 years. Suprapapillary carcinoma showed male-to-female ratio of 1 : 1,the average age of males was 64.5 years and of females was 61.8 years. Infrapapillary carcinoma showed the ratio of 1.9 : 1,and the average age of males was 54.2 and of females 54.1,respectively. The patients of suprapapillary carcinoma were divided into two groups ; one was those with carcinoma in the duodenal bulb, the other was those with carcinoma of the other suprapapillary portions. Infrapapillary carcinoma was also divided ; one group was the carcinoma of the second portion, the other was the carcinoma of the third, fourth and duodenojejunal flexure. Although pathognomonic signs and symptoms were absent in the duodenal carcinoma, obstructing symptoms were prevalent in the distal carcinoma. The frequency of bleeding was almost equal in the four groups. Early carcinoma showed free or vague symptoms. The rate of correct diagnosis of duodenal carcinoma was 50-69% among the groups. Pancreatoduodenectomy was the treatment of choice in the carcinoma of the second portion unrelated to the papillary position. Segmental excision or local resection was adopted in the carcinoma of the duodenal bulb and of the distal position. The longer was the duration of symptoms, the operation became more palliative. Lymph node metastasis was more frequent according as the carcinoma occurred distally. Choice of the operation was restricted not only by the node metastasis, but also by the duration of symptoms, macroscopic form, size and location of carcinoma. The selection of surgical method is mandatory ; however, in order to relieve the symptoms of patients, if palliative, resection of the primary site should be considered in the advanced noncurable cases.
近畿大学の論文
1985-03-25

<総説>原発性十二指腸乳頭上部癌および乳頭下部癌 : 本邦報告例について

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