Evaluation of Resection of the Papilla of Vater for the Treatment of Cancer in the Papilla of Vater
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概要
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We evaluated the resection of the papilla of Vater performed in patients with cancer in the papilla of Vater. The subjects were 6 patients who underwent resection of the papilla of Vater between January 1969 and December 2001. The patients aged 57-87 years consisted of 3 males and 3 females. The maximal diameter of the tumors was 0.5 cm in 1 patient, 1.5 cm in 3 patients, and 2.0 cm in 2 patients. Macroscopically, the tumors were of the protruded type (exposed) in 3 patients, of the mixed type (predominant protruded type) in 2 patients, and of the ulcerative type in 1 patient. The histological depth of the tumors was up to the mucosa in 1 patient, up to the oddi in 1 patient, up to the panc<SUB>0</SUB>, du<SUB>1</SUB> in 1 patient, up to the panc<SUB>1</SUB>, du<SUB>2</SUB> in 1 patient, and unknown in 2 patients. Histologically, the tumors were papillotubular adenocarcinoma (pap-tub) in 4 patients and tubular adenocarcinoma of the well-differentiated type (tubs) in 2 patients. Resection of the papilla of Vater was chosen because of high risk factors such as advanced age in 2 patients, complicated severe cirrhosis and confinement to bed due to poor systemic conditions after intracerebral hemorrhage in 3 patients, and hepatic metastasis observed during surgery in 1 patient. Residual cancer cells around the excised region were positive in 4 patients and unknown in the remaining 2 patients. Of the 6 patients, 5 died within 2 years after surgery, but 1 is alive without symptoms of recurrence 7 years after surgery. The death causes were the primary disease in 3 of the 5 patients. From the viewpoint of radical treatment, resection of the papilla of Vater cannot be chosen as a reduced surgery for cancer in the papilla of Vater. However, resection of the papilla of Vater can be applied to very elderly patients and patients under poor systemic conditions, for whom pancreatoduodenectomy (PD) is considered excessively invasive due to a small diameter of tumor.
- 久留米大学医学部 The Kurume Medical Journal 編集部の論文
著者
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AOYAGI Shigeaki
Department of Cardiovascular Surgery, Kurume University School of Medicine
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Okuda Koji
Department Of Electrical Engineering Faculty Of Engineering Science Osaka University:on Leave Of Abs
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Odo Masaharu
Department Of Surgery Kurume University School Of Medicine
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Shirouzu Kazuo
Department Of Surgery Kurume University
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Kodama Takahito
Department Of Surgery Kurume University Medical Center
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Kawahara Ryuichi
Department Of Surgery Kurume University School Of Medicine
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Yasunaga Masafumi
Department Of Anatomic Pathology Kyushu University Hospital
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Nishimura Kazunori
Department Of Cardiovascular Surgery Nagano Red Cross Hospital
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Matsuo Hideki
Department Of Surgery Kurume University School Of Medicine
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Kinoshita Hisafumi
Department Of Surgery And Oncology Graduate School Of Medical Sciences Kyushu University
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KODAMA TAKAHITO
Department of Surqery, Kurume University School of Medicine
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AOYAGI SHIGEAKI
Department of Surqery, Kurume University School of Medicine
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Hara Masao
Department of Industrial Chemistry, Faculty of Engineering, Yamaguchi University
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YASUNAGA MASAFUMI
Department of Surqery, Kurume University School of Medicine
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SAKAI HISAMUNE
Department of Surqery, Kurume University School of Medicine
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SHIROUZU KAZUO
Department of Gastroenterology and Surgery, Kurume University School of Medicine
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