Cooperman A M
Surg Clin North Am. 1981 Feb;61(1):99-106. doi: 10.1016/s0039-6109(16)42335-2.
The presenting features of periampullary cancer have been reviewed. Unless the neoplasm is discovered as an incidental finding at surgery, diagnosis is not made until the onset of symptoms (pain, jaundice, weight loss), which is not early, even though these tumors are close to the bile duct or ampulla of Vater. Individual philosophies aside, the prognosis for ampullary, duodenal, or distal bile duct tumors reflects the grade and stage of tumor as much as the operation done. Pancreatoduodenal resection, standard or modified, should be done with an attempt to cure and not to palliate. Statistics that show superior results after resection compared with palliative procedures reflect earlier stages lesions, healthier patients, and, most importantly, patient selection.
壶腹周围癌的临床表现已被综述。除非肿瘤在手术中偶然发现，否则直到出现症状（疼痛、黄疸、体重减轻）才会做出诊断，而这些症状出现得并不早，尽管这些肿瘤靠近胆管或 Vater 壶腹。抛开个人观点不谈，壶腹、十二指肠或远端胆管肿瘤的预后在很大程度上反映了肿瘤的分级和分期以及所进行的手术。应进行标准或改良的胰十二指肠切除术，目的是治愈而非姑息治疗。与姑息性手术相比，切除术后显示出更好结果的统计数据反映了病变处于更早阶段、患者更健康，以及最重要的是患者选择。
