J.Jpn. Surg. Soc.. 87(9): 1177-1180, 1986

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Report on the annual meeting

SURGICAL TREATMENT OF PANCREATIC CANCER

Since 1974, 162 patients of pancreatic cancer, 112 patients of the head and 50 patients of the body and tail have been treated with 68.8% and 32.0% resectability. Forty-six cases (59.7%) in 77 resected cases of the head of the pancreas and 9 cases (56.3%) in 16 resected cases of the body and tail were performed combined resection of portal vein and/or hepatic artery. During this period, operative mortality rate were 2.2%.
According to the analysis of 22 autopsys in resected patients, liver metastasis (59%), recurrence at the hilus of the liver (36%), local recurrence (36%) and lymph node metastasis were dominant findings. These facts lead the extented radical operation including dissection of retroperitoneal nerve plexus and second group lymph nodes as standard operatin at pancreatic cancer surgery. As multidisciplinary treatment, intraoperative radiatin with 1,5000－3,000 rad for local recurrence and, continuous administratin of MMC and 5Fu to the portal vein via lig. teres for liver metastasis were performed.
During the same period, small pancreatic cancer, less than 2cm in diameter were 10 cases, 13.0% of resected cases of cancer of the head of the pancreas. All showed obstructive jundice as initial symptom except one. Among diagnostic imagings, superselective angiography showed most accurate size of the tumor. Two patients of small pancreatic cancer are living well 5 years after surgery.

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