[Diagnosis and treatment of 178 patients with carcinoma of the head of pancreas].

OBJECTIVE

To improve the diagnosis and treatment of carcinoma of head of pancreas.

METHODS

A retrospective study was carried out to evaluate 178 patients suffering from carcinoma of head of pancreas.

RESULTS

Pain in the epigastrium and obstructive jaundice were observed in 70% and 74.2% of these 178 patients, both of which were of significance (P < 0.001) between stage I, II and stage III, IV disease. Only 18% of patients had pain in the back, 81.3% of whom belonged to the stage IV category. The detection rate of the tumor by B-ultrasound, CT and MRI were 74.2%, 87.3% and 85.5%, respectively. The success rate of pancreatoduodenectomy was 10.1%. The postoperative 1-, 3- and 5-year survival rates were 67.5%, 36% and 5.6%. Internal drainage was performed in 115 patients. The median survival time was 7 months in patients with unresectable tumor who received radiotherapy and/or chemotherapy.

CONCLUSION

Pain in the epigastrium and obstructive jaundice are the most common symptoms. Hyperglycemia is the most common complication. Pain in the back implies an advanced lesion. CT is the most important way of diagnosis and the combination of B-ultrasound, CT and MRI may improve the rate of diagnosis up to 96.6%. By now, pancreaticoduodenectomy is still the only effective treatment for the carcinoma of head of pancreas and internal drainage is an important palliative measure.