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Papiloduodenectomia como alternativa terapêutica para tumores papilares

Papiloduodenectomy as an alternative treatment for papillary tumors

Resumo

The papiloduodenectomy is a procedure that, although accomplished rarely, has its validity in selected cases of papillary tumors. It is included in this group the patients with important diseases that doesn't have conditions of supporting the surgery of Whipple, the standard procedure for these pathologies. The authors review its experience with four patient carriers of malign neoplasia of the duodenal papila submitted to papiloduodenectomy. All the patients came jaundiced to the admission. The age varied of 62 to 82 years. The ultrassonography, the computed tomography and the endoscopy with biopsy were used for diagnosis and staging, and all the patients presented with initial stages (TI or T2). Two patients were classified as ASA3 and the other two as ASA4, according to the American Society of Anesthesiology. All the diagnoses were proven by the pathological exam of the surgical piece. It is ended that this procedure facilitates to obtain appropriate margins and satisfactory results when indicated of appropriate way.

Ampullectomy; Periampullary tumors; Papiloduodenectomy


Ampullectomy; Periampullary tumors; Papiloduodenectomy

RELATOS DE CASOS

Papiloduodenectomia como alternativa terapêutica para tumores papilares

Papiloduodenectomy as an alternative treatment for papillary tumors

Hamilton Petry de Souza, TCBC-RSI; Jarcedy Machado AlvesII; Marcelo Garcia TonetoIII; Gémerson GabiattiIV; Gilmara PandolfoV

IProfessor Auxiliar da Disciplina de Cirurgia Abdominal e Coordenador do Departamento de Cirurgia da FAMED-PUC-RS, Chefe da Residência Médica em Cirurgia do Trauma do HPS-PA

IIProfessor Auxiliar da Disciplina de Cirurgia Abdominal FAMED-PUC-RS

IIICirurgião do HSL, Aluno do Curso de Pós-Graduação (Mestrado) FAMED-PUC-RS

IVResidente do 2° ano de Cirurgia Geral do HSL-PUC

VDoutoranda da FAMED-PUC-RS

Endereço para correspondência Endereço para correspondência: Dr. Hamilton Petry de Souza Rua Antônio Parreiras, 145/401 90450-050 - Porto Alegre - RS

ABSTRACT

The papiloduodenectomy is a procedure that, although accomplished rarely, has its validity in selected cases of papillary tumors. It is included in this group the patients with important diseases that doesn't have conditions of supporting the surgery of Whipple, the standard procedure for these pathologies. The authors review its experience with four patient carriers of malign neoplasia of the duodenal papila submitted to papiloduodenectomy. All the patients came jaundiced to the admission. The age varied of 62 to 82 years. The ultrassonography, the computed tomography and the endoscopy with biopsy were used for diagnosis and staging, and all the patients presented with initial stages (TI or T2). Two patients were classified as ASA3 and the other two as ASA4, according to the American Society of Anesthesiology. All the diagnoses were proven by the pathological exam of the surgical piece. It is ended that this procedure facilitates to obtain appropriate margins and satisfactory results when indicated of appropriate way.

Key words: Ampullectomy; Periampullary tumors; Papiloduodenectomy.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido em 9/1/98

Aceito para publicação em 1/10/99

Trabalho realizado no Serviço de Cirurgia Geral do HSL-PUCRS. Departamento de Cirurgia FAMED-PUC-RS

  • 1. Haslted WS. Contributions to the surgery of the bile passages, especially of the common bile duct. Boston M. & S J 1899; 141: 645-654.
  • 2. Kazuo C, Yamashita H, Kuroki S. Wide ampullectomy for patients with villous adenoma of duodenal papilla and follow-up results of pancreaticobiliary tract. Int Surg 1994; 79: 178-182.
  • 3. Rivera JA, Rattner DW, Fernandez-del-Castilho C, et al. Surgical approaches to benign and malignant tumors of the ampulla of Valer. Surg Oncol Clin N Am 1996; 5: 689-711.
  • 4. Talamini MA, Moesinger RC, Pitt HA, et al. Adenocarcinoma of the ampulla of Vater: a 28-year experience. Annals of Surgery 1997; 225: 590-600.
  • 5. Asbun HJ, Rossi RL. Local ampullary ressection for ampullary tumors. In Lygidakis NK.: Pitfalls and complications in the diagnosis and management of hiepatobiliary and pancreatic disease. New York: Thieme, 1993 pp 391-4.
  • Endereço para correspondência:

    Dr. Hamilton Petry de Souza
    Rua Antônio Parreiras, 145/401
    90450-050 - Porto Alegre - RS
  • Datas de Publicação

    • Publicação nesta coleção
      31 Maio 2010
    • Data do Fascículo
      Dez 1998

    Histórico

    • Aceito
      01 Out 1999
    • Recebido
      09 Jan 1998
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