The characteristics of different periampullary
cancers, in the order of
carcinoma of head of pancreas (n = 352),
carcinoma of common bile duct (n = 42),
carcinoma of Vater's ampulla (n = 189), and
duodenal cancer (n = 48) were as follows: (1) the mean duration of symptoms were 11.9 +/- 1.3, 5.8 +/- 0.9, 6.3 +/- 0.6, and 18.3 +/- 4.0 weeks (F = 6.18, P < 0.01); (2) the serum total
bilirubin was 225 +/- 10, 345 +/- 35, 235 +/- 13, and 50 +/- 13 micromol/L(chi(2) = 68.49, P < 0.01); (3) the mean
tumor size was 6.0 +/- 2.2, 3.0 +/- 1.3, 3.0 +/- 1.9, and 4.8 +/- 3.9 cm respectively (chi(2) = 255.7, P < 0.01); (4)
adenocarcinoma accounted for 88%. Distant
metastasis occurred in 98 cases, mostly to liver, abdominal cavity, and omentum. Local invasion mainly occurred in duodenum (chi(2) = 10.76, P < 0.01), common bile duct (chi(2) = 15.16, P < 0.01), and periampullary tissues (chi(2) = 22.49, P < 0.01), and great vessels (chi(2) = 51.25, P < 0.01). (5) the T staging (chi(2) = 11.68, P < 0.01) and lymph node status (chi(2) = 8.33, P < 0.05) of the removed
tumor specimens were different among different kinds of
carcinomas; (6) local invasion of duodenum (chi(2) = 10.76, P < 0.01), common bile duct (chi(2) = 15.16, P < 0.001), periampullary tissues (chi(2) = 22.49, P < 0.01), and great vessel (chi(2) = 51.25, P < 0.01) occurred in unresectable
carcinomas; (7) the resection rates were 13% (n = 46), 50% (n = 21), 74% (n = 139), and 56% (n = 27) respectively (chi(2) = 205.6, P < 0.01); (8) the postoperative median survival periods were 6.0 +/- 0.3, 13.0 +/- 1.2, 22.0 +/- 1.6, and 13.0 +/- 2.5 months respectively (chi(2) = 173.47, P < 0.01).
CONCLUSION: