[Transduodenal papillectomy in cancer of the major duodenal papilla].
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Biomedical subjects
Publications and source records attributed to B M Shubin.
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Resection of the bile ducts for cancer was performed in 9 patients. Indications for such operations are well demarcated tumors located in the zone of triple junction of the ducts. Radicality of surgery and improvement of its results are largely contributed by an extensive resection of the duct with removal of the cellular tissue, lymph nodes of the hepatoduodenal ligament with obligatory cholecystectomy. A reconstructive stage should be terminated by constructing hepatico-gastroanastomosis with a controlled transnasal drainage.
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Studies on the clinical course of the lesion in 525 patients with malignant tumors of the bilio-pancreato-duodenal system organs have evidenced that jaundice is not an early sign of the affection. In developed jaundice it is rational to differentiate two main diagnostic stages: presurgical which main task is differentiation between mechanic jaundice and hepatocellular jaundice, the greatest importance being attached to clinical investigation of serum enzymes and clinical data. The second main diagnostic stage is an operation during which all feasible methods of ultimate diagnosis should be employed, including direct cholangiography and urgent microscopy of a tumor.
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