The authors reviewed and reported their institutional experience from 1950 to 1993 in treating seven patients with extrahepatic biliary cystadenomas as well as 19 previously reported cases in the literature. Papillary cystadenoma with foci of invasive adenocarcinoma, thus supporting the malignant potential of cystadenomas, occurred in one patient. No recurrence was reported after formal sleeve resection and bilioenteric reconstruction. Sleeve resection with negative histologic resection margins followed by bilioenteric reconstruction, therefore, is recommended. The authors evaluated the outcome and potential prognostic factors of 60 patients with surgically resected periampullary tumors.
Periampullary carcinomas exhibit different clinical behaviors according to their site of origin.
There are no prognostic factors for deciding the type of surgery to be used or for choosing patients with tumors that have a poor prognosis for adjuvant treatment. A retrospective review was performed of 15 clinical and pathologic variables encountered among 60 patients with periampullary tumors. Tumors were divided into four groups according to their site of origin. Cox's proportional hazards model was used to test for separate and combined independent predictors of disease-free survival. According to the Cox analysis, absence of neural invasion and use of adjuvant chemotherapy were significant factors for longer survival of patients with ampullary tumors.