Tratamiento quirúrgico del cáncer de la ampula de Vater
Resumen
Se analizan 9 casos de cáncer de ámpula de Vater, intervenidos en el Hospital Carlos Andrade Marín, en el año 1994. A ocho enfermos se les realizó, duodenopancreatectomía con preservación del píloro más linfadenectomía retroperitoneal, a un paciente se efectuó pancreaticoduodenectomía cefáUca con la clásica técnica de Whipple. Cuatro pacientes son hombres; 5 mujeres; los síntomas son de ictericia obstructiva más pérdida de peso, y se inician entre 5 y 1 mes antes de su ingreso. El diagnóstico se realizó mediante la biopsia del tumor con la endoscopia digestiva alta y la calingiografía retrógrada en todos los casos. Cuatro pacientes presentaron complicaciones postoperatorias; un hemoperitoneo que necesitó reintervención quirúrgica a las 48 horas, 2 fístulas de la anastomosis biliodigestiva, 1 úlcera en la neoboca duodenoentérica; en estos 3 enfermos hubo ectasia gástrica transitoria. En ocho enfermos el tumor invadía el páncreas. En el postoperatorio todos los pacientes recuperaron peso.
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2. Jochimsen PR; Nathan W; Pearlman. Course and-Treatment results of young patients with carcinoma of the páncreas. Surgery Obs 1977; 144: 132-34.
3. INEC Anuarios de estadísticas hospitalarias 1985 a 1993.
4. INEC Anuarios de estadísticas vitales, nacimientos y defunciones 1985 a 1993.
5. Cáncer en Quito. Registro Nacional de tumores 1992.
6. Monge J . J ; Judd E . S ; Gage R.P. Radical pancreatoduodenectomy. Anri Surg. 1964. 160: 711-22.
7. Neoptolemus J.P; Talbot IC, Carr locke D. L Treatment and outcome in 52 consecutive cases of ampulary carcinoma. Br. J . Surgery 1987; 74: 957-61.
8. Whipple AO. Parsons WB; Mullen CR. Treatment of carcinoma of the ampuUa of Vater. Ann Surg; 1935, 102: 763-79.
9. Whipple AO. Pancreaticoduodenectomy for islot carcinoma a five year follow up. Ann. Surg; 1945; 847-52.
10. Watson K; Carcinoma of ampulla of Vater; Sucessful radical resection Br. J . Surg. 1944, 31: 368-73.
11. Traverso LW; longmire LW. Preservation of the pylorus in pancreaticoduodenectomy Sur. Ginecol. Obstet. 1978; 146: 959-62.
12. Itani, K.M; Coleman R E . Pylorus preserving pancreaticoduodenectomy. A clinical and physiological appraisal. Ann. Surg. 1986; 204: 655-66.
13. Warschaw A L ; Torchiana D L Delayed gastric emptying after pylorus preserving pancreatoduodenectomy. Surg. Ginecol. Obstet 1985; 160: 1-4
14. Newman KD; Braasch JW, Rossi R L Pibric and gastric preservation with pancreatoduódenectomy. Am. J . Surgery 1983; 145: 152-6.
15. Martin FM; Rossi R L ; Braasch JW. Pylorus-preserving pancreatoduódenectomy. Results with 126 consecutive patients. Neth J . Surg. 1988. World Congress on HPB Surgery (Suppl) 194.
16. Moossa AR; Surgical treatment of cronic pancreatitis: an overview. Br. J . Surg. 1987, 74: 661-7.
17. Grace P. A. Pitt, HA; Ix)ngmijre WP. Ia pancreatoduodenectomía con conservación del píloro, una visión de conjunto. Br. J . Surg (Ed. Esp) Volumen 4 No. 6 1990^ 495-99.
18. Moossa AR; Pancreatic Cáncer. Approach to diagnosis selection of surgery and choice of operation Cáncer 1982; 50: 2689-98.
19. Sharp Kw; Ross CB; Falter S.A. et.al. Pancreatoduódenectomy with pilarle preservation for carcinoma of the páncreas A cautionary note. Surgery 1989; 105:645-53.
20. Mosca F; Guüianot; PE; Arganini M; Brand IS. Pancreaticoduodenectomy with pylorus preservation It. J . Surg. Sei 1984; 14: 313-20.
21. Braasch JW; Pancreaticoduodenal resection. Curr. Probl. Surg. 1988; 25: 323-63.
22. Tarazi R Y; F£rman R E ; Vogh DP; et al Results of surgical treatment of periampulary tumours 35 years experience. Surgery 1986; 100 : 716-22.
23. Connolly MM; Dawson P.J.; Michelassi F . Moosa AR. Lowenstein F . Survival in 1001 patiaits with carcinoma of the páncreas Ann. Surg. 1987; 206: 366-73. 2
24. Crist D.W; Sitzmann JV; Cameron J L Improved hospital morbidity, mortality and survival after the Whipple procedure. Ann Surg. 1987 : 358-65.
25. Braasch JW; Rossi R L ; Watkins E ; Pilory and patrie preserving pancreatic resection Ann. Surg. 1986; 204: 411-8.
26. Japan Páncreas Society. General Rules for surgei-y and pathological studies on cáncer of the páncreas (abstract in English) 3ra Ed. Tokyo: Kanehara 1986: 2-5.
27. Desjardius A. Technique de la pancreatectomie Rev. Chir 1907; 35: 945-73.
28. Flautner L Tihanyi, T. Szecseny, A. Pancreatogastrostomy an ideal complement to pancreatic head resection with preservation of the pylorus in the treatment of cronic pancreatitis Ann. J . Surg. 1985; 150: 608-11.
29. Nagakawa, T; Kobayashi H; Ueno, K; Ohta, K; Kayahara m; et al. Clinical study of limphatic flow to the paraaortic limph'nodes in carcinoma of the head of the páncreas. Cáncer 1994; 73: 1155-62.
30. Cubilla A L Fortner J.G; Fitzgerald P.J; Limph node involvement in carcinoma of head of the páncreas área. Cáncer 1978; 41: 880-7.
31. Eagihara, K ; experimental and clinicopathological studies on limphatic flow of the páncreas. Igaku Kenkyu 1982; 52: 61-85 (in japanese).
32. Nakao, A; Takeda, N ; Kasuga, T ; Significance of dissection of paraortic limph nodes in pancreatic cáncer. Jpn. J . Surg. Ass. 1990, 21: 23-6 (in Ja-panesej.
33. Kim, ¥€; Suzuki T, Kajiwara, T; Miyasiiita, T; Tobe, T; Exocrine and endocrine stomacha after gastro bulbar preserving pancreatoduonenectomy. Ann. Surg. 1987; 206: 717-27.
34. Braash, J.W, Rossi R L , Walkings, E , Winter PF. Piloric and gastric preserving pancreatic resection Ann. Surg. 1986; 205: 411-8.
35. Williamson, RCN; Cooper, MJ; Resection in cronic pancreatitis Br. J Surg. 1987; 74: 807-12.
36. Braasch, JW; Gongliang Y; Rossi, R, Pancreatoduódenectomy with preservation of the püorus. World J . Surg. 1984, 8: 900-5.
37. Braasch JW; Rossi R. Pyloric and gastric preserving pancreatic resection. Experience with 87 patients Ann. Sui^. 1988; 204: 411-5.
38. Belli, U Riólo, F; Romani, F, et.al. Pylorus preserving pancreaticoduodenectomy, versus Whipple procedure for adenocarcinoma of the head of the páncreas H.P.B. Surg. 1989; 1: 195-200.
39. Kairaluoma, M.I; Stahlberg, M; Kiwimieni, H; Pancreatic resection for carcinoma of the pancreas and periampullar región HPB. Surg. 1990; 2: 57-67.
40. Fortner J.G. Regional pancreatectomy for cáncer of the páncreas ampulla, and other related sites. Ann. Surg. 1984; 199: 418-425.
2. Jochimsen PR; Nathan W; Pearlman. Course and-Treatment results of young patients with carcinoma of the páncreas. Surgery Obs 1977; 144: 132-34.
3. INEC Anuarios de estadísticas hospitalarias 1985 a 1993.
4. INEC Anuarios de estadísticas vitales, nacimientos y defunciones 1985 a 1993.
5. Cáncer en Quito. Registro Nacional de tumores 1992.
6. Monge J . J ; Judd E . S ; Gage R.P. Radical pancreatoduodenectomy. Anri Surg. 1964. 160: 711-22.
7. Neoptolemus J.P; Talbot IC, Carr locke D. L Treatment and outcome in 52 consecutive cases of ampulary carcinoma. Br. J . Surgery 1987; 74: 957-61.
8. Whipple AO. Parsons WB; Mullen CR. Treatment of carcinoma of the ampuUa of Vater. Ann Surg; 1935, 102: 763-79.
9. Whipple AO. Pancreaticoduodenectomy for islot carcinoma a five year follow up. Ann. Surg; 1945; 847-52.
10. Watson K; Carcinoma of ampulla of Vater; Sucessful radical resection Br. J . Surg. 1944, 31: 368-73.
11. Traverso LW; longmire LW. Preservation of the pylorus in pancreaticoduodenectomy Sur. Ginecol. Obstet. 1978; 146: 959-62.
12. Itani, K.M; Coleman R E . Pylorus preserving pancreaticoduodenectomy. A clinical and physiological appraisal. Ann. Surg. 1986; 204: 655-66.
13. Warschaw A L ; Torchiana D L Delayed gastric emptying after pylorus preserving pancreatoduodenectomy. Surg. Ginecol. Obstet 1985; 160: 1-4
14. Newman KD; Braasch JW, Rossi R L Pibric and gastric preservation with pancreatoduódenectomy. Am. J . Surgery 1983; 145: 152-6.
15. Martin FM; Rossi R L ; Braasch JW. Pylorus-preserving pancreatoduódenectomy. Results with 126 consecutive patients. Neth J . Surg. 1988. World Congress on HPB Surgery (Suppl) 194.
16. Moossa AR; Surgical treatment of cronic pancreatitis: an overview. Br. J . Surg. 1987, 74: 661-7.
17. Grace P. A. Pitt, HA; Ix)ngmijre WP. Ia pancreatoduodenectomía con conservación del píloro, una visión de conjunto. Br. J . Surg (Ed. Esp) Volumen 4 No. 6 1990^ 495-99.
18. Moossa AR; Pancreatic Cáncer. Approach to diagnosis selection of surgery and choice of operation Cáncer 1982; 50: 2689-98.
19. Sharp Kw; Ross CB; Falter S.A. et.al. Pancreatoduódenectomy with pilarle preservation for carcinoma of the páncreas A cautionary note. Surgery 1989; 105:645-53.
20. Mosca F; Guüianot; PE; Arganini M; Brand IS. Pancreaticoduodenectomy with pylorus preservation It. J . Surg. Sei 1984; 14: 313-20.
21. Braasch JW; Pancreaticoduodenal resection. Curr. Probl. Surg. 1988; 25: 323-63.
22. Tarazi R Y; F£rman R E ; Vogh DP; et al Results of surgical treatment of periampulary tumours 35 years experience. Surgery 1986; 100 : 716-22.
23. Connolly MM; Dawson P.J.; Michelassi F . Moosa AR. Lowenstein F . Survival in 1001 patiaits with carcinoma of the páncreas Ann. Surg. 1987; 206: 366-73. 2
24. Crist D.W; Sitzmann JV; Cameron J L Improved hospital morbidity, mortality and survival after the Whipple procedure. Ann Surg. 1987 : 358-65.
25. Braasch JW; Rossi R L ; Watkins E ; Pilory and patrie preserving pancreatic resection Ann. Surg. 1986; 204: 411-8.
26. Japan Páncreas Society. General Rules for surgei-y and pathological studies on cáncer of the páncreas (abstract in English) 3ra Ed. Tokyo: Kanehara 1986: 2-5.
27. Desjardius A. Technique de la pancreatectomie Rev. Chir 1907; 35: 945-73.
28. Flautner L Tihanyi, T. Szecseny, A. Pancreatogastrostomy an ideal complement to pancreatic head resection with preservation of the pylorus in the treatment of cronic pancreatitis Ann. J . Surg. 1985; 150: 608-11.
29. Nagakawa, T; Kobayashi H; Ueno, K; Ohta, K; Kayahara m; et al. Clinical study of limphatic flow to the paraaortic limph'nodes in carcinoma of the head of the páncreas. Cáncer 1994; 73: 1155-62.
30. Cubilla A L Fortner J.G; Fitzgerald P.J; Limph node involvement in carcinoma of head of the páncreas área. Cáncer 1978; 41: 880-7.
31. Eagihara, K ; experimental and clinicopathological studies on limphatic flow of the páncreas. Igaku Kenkyu 1982; 52: 61-85 (in japanese).
32. Nakao, A; Takeda, N ; Kasuga, T ; Significance of dissection of paraortic limph nodes in pancreatic cáncer. Jpn. J . Surg. Ass. 1990, 21: 23-6 (in Ja-panesej.
33. Kim, ¥€; Suzuki T, Kajiwara, T; Miyasiiita, T; Tobe, T; Exocrine and endocrine stomacha after gastro bulbar preserving pancreatoduonenectomy. Ann. Surg. 1987; 206: 717-27.
34. Braash, J.W, Rossi R L , Walkings, E , Winter PF. Piloric and gastric preserving pancreatic resection Ann. Surg. 1986; 205: 411-8.
35. Williamson, RCN; Cooper, MJ; Resection in cronic pancreatitis Br. J Surg. 1987; 74: 807-12.
36. Braasch, JW; Gongliang Y; Rossi, R, Pancreatoduódenectomy with preservation of the püorus. World J . Surg. 1984, 8: 900-5.
37. Braasch JW; Rossi R. Pyloric and gastric preserving pancreatic resection. Experience with 87 patients Ann. Sui^. 1988; 204: 411-5.
38. Belli, U Riólo, F; Romani, F, et.al. Pylorus preserving pancreaticoduodenectomy, versus Whipple procedure for adenocarcinoma of the head of the páncreas H.P.B. Surg. 1989; 1: 195-200.
39. Kairaluoma, M.I; Stahlberg, M; Kiwimieni, H; Pancreatic resection for carcinoma of the pancreas and periampullar región HPB. Surg. 1990; 2: 57-67.
40. Fortner J.G. Regional pancreatectomy for cáncer of the páncreas ampulla, and other related sites. Ann. Surg. 1984; 199: 418-425.
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2017-06-29
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1.
Chávez Estrella J, Chávez Guerrero M. Tratamiento quirúrgico del cáncer de la ampula de Vater. Rev Fac Cien Med (Quito) [Internet]. 29 de junio de 2017 [citado 3 de abril de 2025];20(1-2):10-21. Disponible en: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/793
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