[Duodenal tumors].

Tumors of the duodenum are relatively rare, accounting for about 1-2% of all gastrointestinal neoplasms. Nevertheless diagnosis and therapy are important, as 50% of all duodenal neoplasms are malignant. In the period 1987-1992 we treated 14 patients with duodenal neoplasms (11 men, 3 women, age 30-81 years [median 60.4]). 5 patients had undergone previous treatment for malignant tumors (4 genito-urinary tract, 1 rectum). The main symptoms were pain (43%), malaise (43%), weight loss (43%), anemia (28%), jaundice (28%), obstruction (22%), nausea and/or vomiting (22%). Diagnostic investigations were upper endoscopy (93%), computed tomography of the abdomen (72%), angiography or duplex-sonography (22%). Preoperative histology was malignant in 43%, benign in 22% and unclear in 35%. Surgery consisted of the following: duodenopancreatectomy (Whipple procedure) in 4 (31%), segmental resection in 2 (15%), local resection in 2 (15%), transduodenal excision of the ampulla of Vater in 1 (7.5%), modified Finney pyloroplasty in 1 (7.5%), gastroenterostomy in 2 (15%) and choledocho-jejunostomy in 1 (7.5%). One patient refused surgery or chemotherapy. The definitive histologies in the 13 operated cases were adeno-carcinoma in 8 (62%), leiomyosarcoma in 1 (8%), leiomyoma in 2 (15%), and tubulo-villous adenoma in 2 (15%). The tumors were located in pars I in 3 (22%), in pars II in 9 (64%) and in pars III in 2 (14%). There were no postoperative complications in 9 patients (70%). 2 patients had an abscess of the abdominal wall or multiple entero-cutaneous fistulas, and 2 patients died from multiple organ system failure. The 30-day mortality was 15.4% (2/13).(ABSTRACT TRUNCATED AT 250 WORDS)