Surgical Treatment for Carcinoma of the Ampulla of Vater and Residual Pancreatic Function before and after Pancreaticoduodenectomy

Examination was made on long-term survival rates of 23 cases on which operation for carcinoma of the ampulla of Vater was performed, as well as on the residual pancreatic fuctions of the cases on which pancreaticoduodenectomy (PD) was done, by the authors during the period from 1969 to 1982.

PD was done on 17 cases, and the resectability was 74%, without any operative death. The number of survived patients for more than five years was five (42%), and the mean survival period was 45 months. These results of carcinomas of the ampulla were better than those of other periampullary cancers.

The endocrine pancreatic function was determined with the oral glucose tolerance test, and in 79 % of the cases, abnormalities of glucose tolerance were observed preoperatively, whereas those aggravated postoperatively were found in 21% of the cases.

The exocrine pancreatic function was determined with the Pancreatic Function Diagnostant test (PFD). The total excretion level of urinary PABA in six hours determined in more than 12 months postoperatively was significantly improved, as compared with that determined preoperatively and. within two months postoperatively. The residual function of exocrine pancreas could be expected to recover in more than 12 months after PD, and the PFD proved to be useful for the follow-up.