Catania Antonio, Falvo Laura, D'Andrea Vito, Sorrenti Salvatore, Dibra Arvin, Foti Nicola, Biancafarina Alessia, Vanni Benedetta, De Antoni Enrico
Division of General Surgery, Department of Surgical Sciences, University of Rome La Sapienza, Rome.
Chir Ital. 2002 Nov-Dec;54(6):883-8.
Carcinoma of the papilla is a rare cancer of the digestive tract; 5% of all gastrointestinal tract malignant neoplasms are periampullary. The authors report and discuss the case of one of their patients aged 79 years suffering from a tumour of the papilla. The case was characterized by the large size of the neoplasm (5.5 cm in diameter) and by the poor clinical conditions of the patient, who was suffering from Parkinson's disease and was at high operative risk. The surgical strategy chosen involved transduodenal excision of the tumour with duodenum-bile duct anastomosis and internal duodenum-Wirsung duct anastomosis. The authors first examine the hypothesis that carcinoma of the papilla may represent the evolution of an adenomatous lesion and then go on to assess the therapeutic strategy adopted in the treatment of these neoplasms: in patients at high operative risk a transduodenal excision of the tumour with duodenum-bile duct anastomosis and internal duodenum-Wirsung duct anastomosis may be a valid alternative to the conventional Whipple procedure.
乳头癌是一种罕见的消化道癌症；所有胃肠道恶性肿瘤中有5%是壶腹周围癌。作者报告并讨论了一名79岁患有乳头肿瘤患者的病例。该病例的特点是肿瘤体积大（直径5.5厘米）以及患者临床状况不佳，患者患有帕金森病且手术风险高。所选择的手术策略包括经十二指肠切除肿瘤并进行十二指肠 - 胆管吻合术以及十二指肠 - 胰管内吻合术。作者首先探讨乳头癌可能代表腺瘤性病变演变的假说，然后继续评估在这些肿瘤治疗中所采用的治疗策略：对于手术风险高的患者，经十二指肠切除肿瘤并进行十二指肠 - 胆管吻合术以及十二指肠 - 胰管内吻合术可能是传统惠普尔手术的有效替代方案。
