[Clinical application of extended resection of Vater's papilla].

OBJECTIVE

To report the surgical technique and clinical application of extended resection of Vater's papilla (ERVP).

METHODS

ERVP was performed in 12 selected patients with tumors of ampulla of Vater according to the following criteria: (1) no signs of distant mestastasis before operation; (2) no hepatic and peritoneal mestastasis during exploration, frozen section of peripancreas-duodenal lymph nodes being negative; (3) tumor less than 2 cm in diameter, pathologic examination of tumor being adenocarcinoma or adenoma; (4) pathologic examination of edge of resection being negative.

RESULTS

There was no operative death nor complications in 12 cases treated by ERVP. The average time of operation was 2.3 hours, the average amount of blood infused was 433 ml, and the average time of hospitalization was 15.8 days. In 5 of 10 cases of Vater's ampullary adenocarcinoma, the mean survival time was 42 months (36-62 months). The remaining 5 cases are still alive at 20-64 months. Two patients with Vater's ampullary adenoma still survive at 32 and 46 months, respectively.

CONCLUSION

ERVP is easy to perform with comparatively less surgical trauma and complication, but redical excision of tumor is not easy. It may be particulary indicated for older and high-risk patients, or patients with cancer less than 2 cm in diameter.