Langer B, Lipson R, McHattie J D, Connon J J, Ho C S, McLoughlin M J, Phillips M J, Tao L C
Can J Surg. 1979 Jan;22(1):34-7.
Forty-five carcinomas of the region of the ampulla of Vater were resected at the Toronto General Hospital during a 16-year period. In 26 the presenting symptom was pain and in 32 it was jaundice. The most useful means of investigation was endoscopic retrograde cholangiopancreatography. Angiography was of value in determining resectability prior to operation, and percutaneous aspiration biopsy allowed a preoperative diagnosis in the case of large pancreatic tumours. In 39 patients who had a Whipple procedure the operative mortality was 8%. Total pancreatectomy performed in two patients and local excision of ampullary carcinoma in four patients were attended by no operative deaths. Long-term survival was best in patients with ampullary carcinomas and worst in those with pancreatic cancer.
在16年期间，多伦多综合医院对45例 Vater壶腹区域癌进行了切除。26例患者的首发症状为疼痛，32例为黄疸。最有用的检查手段是内镜逆行胰胆管造影。血管造影在术前确定可切除性方面有价值，经皮穿刺活检可在胰腺大肿瘤的情况下进行术前诊断。39例行Whipple手术的患者手术死亡率为8%。2例行全胰切除术和4例行壶腹癌局部切除术的患者均无手术死亡。壶腹癌患者的长期生存率最高，胰腺癌患者的长期生存率最低。
