Periampullary carcinoma: An audit of an institutional experience with literature review

Background: Periampullary carcinoma constitutes a distinct entity as compared to the classical pancreatic head cancer. Diagnosis, management and prognosis have improved considerably in the last few decades. The present study looks into the modes of presen-tation in patients with periampullary carcinoma, the different modalities of investigations, treatment along with the postoperative morbidity and mortality. Material and Methods: A retrospective and prospective observational study was done at Kasturba Medical College, Manipal Universi-ty, India between January 2007 and December 2009 and patients diagnosed to have periampullary carcinoma were included. Results: A total of 48 patients were studied, out of which, majority, i.e., 26 (54.16%) had carcinoma head of pancreas. Eight (16.66%) patients had carcinoma of duodenum and eight (16.66%), carcinoma of ampulla of Vater. Thirteen (27.08%) patients with resectable tumors underwent pancreatoduodenectomy (Whipple's operation) while remaining 13 (27.08%) underwent palliative bypass sur-gery. Post Whipple's operation mortality was less than 10%. Conclusions: Periampullary cancers vary in outcome after potentially curative resections that are well standardized. Tumor biology may play a crucial role in these differences.