MALIGNANCY OF THE BILIARY DUCTS AND PERIAMPULLARY REGION : STUDY OF DIAGNOSTIC AND THERAPEUTIC MODALITIES

Abstract

This study was carried out on 52 patients.. 28 patients were males and 24 were females. Their ages ranged from 35 to 74 years. Patients were divided according to their types of lesion into two groups. Group A (cholang.) included 10 patients had C.B.D. tumor (cholangiocarcinoma). This group was further divided into: six patients had upper third C.B.D. tumor (Klatskin tumor), and four patients had middle third C.B.D. tumor. Group B (periamp.) included 42 patients. This group was further divided into: 12 patients had lower third C.B.D. tumor, 10 patients had ampullary tumor, and 20 patients had pancreatic head tumor. The main presenting symptom in this study was jaundice. It accounted for 92.3%. Other symptoms included: abdominal pain, vomiting, fever, and abdominal mass. Most of the patients had a gradual onset of their symptoms. Duration of symptoms ranged from two weeks to one month was experienced in 55.8% of the patients. The least incidence 9.6% of patients experienced one to two months duration of symptoms. More than 90% of patients had a progressive course of the disease. Surgical history of the patients revealed that six p tients had previous cholecystectomy. Regarding the medical history of studied patients; history of schistosoma!affection was present in 12 patients, diabetes mellitus in 11 patients, and hypertension in four patients.