Background: The aim of this study was to evaluate the clinical efficiency of transduodenal ampullectomy (TDA)\ncompared to conventional pancreatoduodenectomy (PD) in patients with early ampullary cancers.\nMethods: We carried out a retrospective study by reviewing the medical records of 43 patients with early\nampullary cancer who underwent either TDA or PD from January 2001 to December 2014. TDA and PD were\nperformed on 22 patients and 21 patients, respectively. Clinical data, perioperative clinical outcomes and prognosis\nwere evaluated. The median follow-up was 75 (range, 38ââ?¬â??143) months.\nResults: The sensitivity of intraoperative frozen resection was 100 % (4/4) and 94.9 % (37/39) in patients with pTis\nand pT1 tumors compared to final histologic diagnoses. The 5-year survival rate of patients with early ampullary\ncancer was 77.3 % in TDA group and 75.9 % in PD group (P = 0.927). Patients with lymph node metastasis\npresented a shorter 5-year survival rate (P = 0.014). TDA was associated with lower surgical morbidity (P = 0.033),\nestimated blood loss (P = 0.002), medical cost (P = 0.028) compared to PD. No pancreatic fistula and surgical\nmortality occurred in TDA group.\nConclusions: TDA could produce satisfactory clinical efficiency in patients fulfilled the following criteria\nsimultaneously: pTis or pT1 stage, tumor size ââ?°Â¤ 2 cm, without lymph node metastasis. To achieve favorable\noutcomes, intraoperative frozen section examinations should be reliable and resection margins should be negative.
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