6533b85ffe1ef96bd12c1ddc

RESEARCH PRODUCT

Surgical treatment of pancreatic cancer

subject

description

From 1964 to 1982, there were 782 patients treated for carcinoma of the pancreas. In 174 patients pancreaticoduodenal resection was possible (22%). Until 1977 we performed Whipple procedures, while from 1978 to 1982 total pancreatectomy was preferred. Comparing the results of both methods, we did not find any advantages of total pancreatectomy. Operative mortality did not decrease, survival time did not extend, and the higher resection rates (up to 26%) for more advanced tumor stages were accompanied by greater morbidity. With respect to the patients with inoperable cancer of the pancreas, we found over the last 5 years that the rate of those not undergoing surgery has climbed from 8% to 25%, while the rate of exploratory laparotomies was reduced from 28% to 5%. With the advent of preoperative percutaneous transhepatic cholangio-drainage (PTCD), the mortality rate of our palliative procedures dropped to 12%. Biliodigestive anastomosis of choice is the hepaticojejunostomy.