J.Jpn. Surg. Soc.. 83(9): 1051-1054, 1982

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Report on the annual meeting

PROBLEMS IN THE SURGICAL TREATMENT FOR PANCREATIC CANCER

Carcinoma of the pancreas is increasing in frequency, although its resectability and prognosis is exceedingly poor. There are many problems in the surgical therapy for pancreatic cancer. One of them is operative procedure, which involves pancreaticoduodenectomy and total pancreatectomy. The choice of these operation is still not clear. On the case of pancreaticoduodenectomy, curability of this disease, operative techniques and postoperative care should be arguable. Of 30 patients who underwent radical operation for carcinoma of the head of the pancreas, lymph nodal metastases were observed in 82.1% of cases and serosal infiltration was in 64.3% of cases. Furthermore, the invasion to lymph vessels was found in 67.9% of cases and venous invasion was in 53.6% of cases. In cases which did not have serosal infiltration, lymph nodal metastases were found in 10-30%. On the other hand, the cases which had serosal infiltration showed higher rate, 33-56% on lymph nodal metastasis, and much more distant spread was observed.
Long term survival was found in only a few cases. In most of cases recurrence occurred shortly after opevation, as cancer of the pancreas was characterized by quick spread into lymphvessel or vein even when the tumor was small.

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