J.Jpn. Surg. Soc.. 91(9): 1249-1251, 1990

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Report on the annual meeting

CLINICAL EXPERIENCE WITH EXTENDED PANCREATIC RESECTION FOR ADENOCARCINOMA OF THE HEAD OF THE PANCREAS

During 1978 and 1989, 465 patients were diagnosed as carcinoma of the head of the pancreas and 224 patients underwent pancreatic resections with resectability of 48.2%. One handred and fifty-three patients with ductal adenocarcinoma of the head of the pancreas had extended radical pancreatectomy (Whipple resection in 134 patients, total pancreatectomy in 19 patients), including R2 lymphadenectomy and dissection of the retroperitoneal tissue in 145 patients, dissection of the nervous plexus around the superior mesenteric artery in 121 patients, portal resection in 100 patients, arterial resection in 10 patients. Forty-two patients (27.5%) had curative resection which was histologically confirmed. The over all operative mortality was 3.1%. There were 4 operative deaths early in this series, but there has been no operative mortality in last 5 years. Five patients who had curative operations survived more than 5 years after the operations, whereas all patients with noncurative operations died within 3 years. Of the 5 patients survived more than 5 years, 3 patients had portal resection because of the tumor invasion to the portal vein. Extended pancreatic resection can be done with acceptably low mortality and the curative operations can produce the only chance for long-term survival for patients with ductal adenocarcinoma of the pancreas.

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