Pancreatic Resection for Carcinoma ofthe Pancreas and the PeriampullaryRegion. A Twenty-Year Experience

摘要

410 patients were treated for pancreatic and periampullary carcinoma in 1968–1987 of whom 89 (21.5%) underwent resection. Hospital mortality decreased from 33% in 1968–1972 to 0% in 1983–1987, but themorbidity rate remained unchanged. The trends were similar in patients ≥ 70 and < 70 years of age. Thepylorus-saving technique did not increase mortality, morbidity, operative blood loss or the incidence ofdelayed gastric emptying, but it did reduce the operative time by one hour (p< 0.01). The real 5 year survivalfor periampullary cancer was 52%, but none of the patients with pancreatic carcinoma survived for 5years.It is concluded that age as such is not a limiting factor for pancreatic resection. Resection can beperformed with acceptable mortality and survival rates even in patients over 70 years of age if enoughattention is paid to careful patient selection and proper preparation. The long-term prognosis is neverthelessrelated to tumour histology. The recent decline in operative mortality is mostly due to the resectionsbeing performed by the same group of surgeons. The best biopsy, and also palliation, is radical removal ofthe suspicious mass, provided that this can be performed with minimal risk.