الفهرس 
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Abstract
This study was carried out at Mansoura Gastrointestinal Surgical Center from June 1995 to June 2000 as a retrospective study on 728 patients with carcinoma of head of pancreas. All cases were diagnosed clinically, laboratory and radiologically and they were classified into three groups:Group I :136 patients had whipple’s operation for operable cases.Group II: 176 patients with advanced tumours undergone¬ palliative surgery as hepaticojejunostomy and or gastrojejunostomy . Group III: 389 patients had advanced tumours and treated by stent, percutaneous transhepatic drainage¬ (P.T.D), 33 of them treated by regional chemo¬ immutherapy. The distribution of 728 patients is categorized by destrict, age, sex, pain, jaundice, tumour, site, Tumour size, tumour differentiation. It was evident that 50% cases were from Dakahlia district, followed by Gharbia district (21%).The mean age of patients who had done whipple’s operation was 52.9±11.6 years with the highest incidence (34.3%) at age between 50-59 years.In patients with advanced tumours who had done other surgery or chemoimmunotheropy the mean age was 54.11±10.5 years with highest incidence (31.2%) at age 50-59 years. The mean age was 55.1±14 years in advanced inoperable cases with higher incidence at age of 60-69 years. As regard male:female distribution in whole groups it was 67.3%-32.7%.Pain was common presentation in advanced group (82%and 81.7%) than group done whipples surgery (71.8%).Jaundice was common presentation in different groups (92.6%, 85.3% and 96.6% in group I, II , and III ).Tumour site was periampullary in 31.9% and of head in 68.1 % cases had done whipples operation and was 10.2% periampullary and 89.8% of head in advanced group had done other surgery or chemoimmunotherapy, while periampullory tumour was 19.85% and 80.2% of head in advanced group without surgery. Mean tumour size was smaller (3.6:f:1.4 cm) in group done whipples operation while it was larger in size in the other two groups (5.4:f:1.9 cm, 5.6:f:1.9cm). Ag regard tumour differentiation, differentiated carcinoma was 51.5% in whipples group and 20.8% in other surgeries group. Moderately differentiated carcinoma were 37.3% in whipples group and 79.2% in other surgeries group.The median survival for patients had done whipples operation was 18 months while 5 years survival was only for those have who had periampullary Carcinoma and it was only 6%,the median srurvival of patients treated by chemoimmunotherapy for advanced carcinoma was 6.5 months while it was 5.5 months for All advanced cases.