Distribution and pathological features of XXXX resected with pancreaticoduodenectomy.

@entity5 @entity788 @entity3
BACKGROUND: @entity788 ( @entity788 ) has the worst survival of all periampullary @entity5 . This may relate to histopathological differences between @entity5 . Our aim was to examine the distribution and histopathologic features of @entity788 resected with a pancreaticoduodenectomy (PD) and to examine @entity5 resected with a PD. METHODS: A retrospective review of PD between January 2000 and December 2012 at a public metropolitan database was performed. The institutional ethics committee approved this study. RESULTS: There were 142 PDs during the study period, of which 70 cases were pre-2010 and 72 post-2010, corresponding to a recent increase in the number of cases. Of the 142 cases, 116 were for periampullary @entity5 . There were also proportionately more PD for @entity788 (26/60, 43% pre-2010 vs 39/56, 70% post-2010, P   =   0.005). There were 65/116 (56%) pancreatic, 29/116 (25%), ampullary, 17/116 (15%) biliary and 5/116 (4%) @entity5 . Nodal involvement occurred more frequently in @entity788 (78%) compared to ampullary (59%), biliary (47%) and @entity5 (20%), P   =   0.002. Perineural invasion was also more frequent in @entity788 (74%) compared to ampullary (34%), biliary (59%) and @entity5 (20%), P   =   0.002. @entity3 was seen in 57% pancreatic, 38% ampullary, 41% biliary and 20% @entity5 , P   =   0.222. Overall, clear margins (R0) were achieved in fewer @entity788 41/65 (63%) compared to ampullary 27/29 (93%; P   =   0.003) and @entity5 16/17 (94%; P   =   0.014). CONCLUSIONS: This study highlights that almost half of PD was performed for @entity5 other than @entity788 , mainly ampullary and @entity5 . The volume of PD has increased in recent years with an increased proportion being for @entity788 . @entity788 had higher rates of nodal and perineural invasion compared to ampullary, @entity5 .
