Adenocarcinoma of the Pancreas : The Clinical Experience of 45 Histopathologically Proven Patients, a 6 Year Study
PINIT KULLA VA NUA YA, M.B., Ch.B. (Leeds), M.R.C.P. (UK)*, SOMBAT TREEPRASERTSUK, M.D., M.Sc., F.R.C.P. (T)**,
DUANGPORN THONG·NGAM, M.D., M.SC., F.R.C.P. (T)***, NUSONT KLADCHAROEN, M.D., M.R.C.P. (UK)*,
VA ROCHA MAHACHAI, M.D.*, PONGSEPEERA SUW ANAGOOL, M.D.****
Affiliation : * Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Chulalongkom University,
** Gastroenterology Unit, Department of Tropical Medicine, Faculty of Tropical Medicine, Mahidol University,
Bangkok l 0400,
*** Department of Physiology,
**** Department of Pathology, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.
AbstractA retrospective study of 45 cases of adenocarcinoma of the pancreas at Chulalongkorn
University Hospital from 1993 to 1998 was reviewed by clinical and histopathological criteria.
Male and female ratio was 25:20. The mean age of the patients was 59.5 ± 10.0 years. The com
mon presenting symptoms and signs were epigastric discomfort (80.0%), weight loss (60.0%) and
jaundice (51.1%). Twenty four patients (53.3%) were screened for a tumor marker (CA 19-9) and
87.5 per cent of these had high level of CA 19-9 (> 37 IU/ml). Thirty five patients (77.8%) had
tumors located in the head of the pancreas. Most of the cases were investigated by using radio
logical imaging (ultrasonography or computerized tomography of the abdomen). Thirty five histo
pathological data (77 .8%) were made by the operation, and the rest (22.2%) were performed by a
fine needle aspiration from the pancreatic mass or liver metastasis. Whipple operation and the
bypass procedure were the most common surgical procedures in our studies. Twenty five patients
(55.6%) had post treatment complications from all modalities consisting of gastrointestinal bleed
ing, respiratory failure and infection. However, the mortality rate within 30 days postoperatively
was 8.11 per cent which was due to blood loss during the operation and infections. The post treat
ment mortality rate from all modalities was 33.3 per cent. The average duration from the diagnosis
until death was 82.3 days.
Keywords : Adenocarcinoma, Pancreas, Clinical, Histopathological
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