[Cancer of the head of the pancreas: clinical, diagnostic and therapeutic aspects at Bamako]. / Cancer du pancreas cepihalique: aspects cliniques, diagnostiques et thérapeutiques à Bamako.

ABSTRACT

OBJECT to determine the relative frequency of the cancer of the head of the pancreas in our structures of 3(ieme) reference to Bamako as well as the diagnostic and therapeutic aspects. PATIENTS AND METHODS: It is about a descriptive retrospective study in the services of general surgery of the Hospital of the Point G and the Hospital Gabriel Touré from January 2000 to June 2004. Were included in the study all the patients presenting a malignant tumour of the head of the pancreas having been confirmed by a histological examination. RESULTS: 26 patients were listed, that is to say 0.3% of the hospitalizations for the period of the study. The reason for hospitalization was an abdominal mass in 57.14% of the cases. The average age of the patients was 58 years. The sex ratio was 42 in favour of the men. Clinical signs of cholestase with type of jaundice frankly accompanied by prurit were present at the clinical examination in 95.24% of the cases. The other signs were the pain, a palpable mass, a ascite representing respectively 71.43%, 66.67%, 23.81% of the cases, Abdomino-pelvic echography allowed the diagnosis in 90% of the cases and the scanner in 100% of the cases. The rate of bilirubine total and free as well as the rates of transaminases (ASAT, ALAT) was high in respectively 95.24% and 85.71% of the cases, The curative therapy consisted of a duodeno-pancreatectomy in 9 cases (39.16% of the cases). A double palliative bilio-digestive derivation was carried out in treatment in 53.84 of the cases, The histological type was the adenocarcinomist in 95.24% of the cases. The rate of survival to 1 year was 10.5% in the event of curative treatment and 5.3% in the event of palliative treatment. CONCLUSION: The diagnosis of cancers of the head of the pancreas is posed at late stages in our structures. The DPC is feasible but the rate of resecability is weak. The palliative treatment can help to improve the quality of life of the patients.