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. 1983 Nov;198(5):605–610. doi: 10.1097/00000658-198311000-00008

Factors influencing survival after total pancreatectomy in patients with pancreatic cancer.

A Andrén-Sandberg, I Ihse
PMCID: PMC1353132  PMID: 6639161

Abstract

A retrospective analysis of factors influencing short-term and long-term survival after total pancreatectomy for pancreatic cancer was done in 86 patients. Among the 41 factors studied, hospital mortality was significantly affected by age over 70 years, preoperative diabetes, pain as presenting symptom, S-bilirubin, preoperative bile drainage, prophylactic antibiotic treatment, stage of the tumor, and experience of the surgeon. The only factors which had a statistically significant influence on long-term survival were stage of the tumor and sex of the patient. It is concluded that improvement of long-term survival can mainly be achieved by earlier identification and removal of the tumors and by introduction of more efficient adjuvant therapy. Whereas these goals probably will require a long time to be reached, the majority of factors associated with worsening of hospital mortality may be avoided by a strict selection of the patient, the tumor and the surgeon.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Björck S., Svensson J. O., Macpherson S., Edlund Y. Cancer of the head of the pancreas and choledochoduodenal junction: a clinical study of 88 Whipple resections. Acta Chir Scand. 1981;147(5):353–359. [PubMed] [Google Scholar]
  2. Bloom P., Steer M. L. Pancreatoduodenectomy. Results when the operation is performed infrequently. Arch Surg. 1975 Dec;110(12):1455–1457. doi: 10.1001/archsurg.1975.01360180025005. [DOI] [PubMed] [Google Scholar]
  3. Braasch J. W., Gray B. N. Considerations that lower pancreatoduodenectomy mortality. Am J Surg. 1977 Apr;133(4):480–484. doi: 10.1016/0002-9610(77)90135-0. [DOI] [PubMed] [Google Scholar]
  4. Edis A. J., Kiernan P. D., Taylor W. F. Attempted curative resection of ductal carcinoma of the pancreas: review of Mayo Clinic experience, 1951-1975. Mayo Clin Proc. 1980 Sep;55(9):531–536. [PubMed] [Google Scholar]
  5. Gilsdorf R. B., Spanos P. Factors influencing morbidity and mortality in pancreaticoduodenectomy. Ann Surg. 1973 Mar;177(3):332–337. doi: 10.1097/00000658-197303000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hatfield A. R., Tobias R., Terblanche J., Girdwood A. H., Fataar S., Harries-Jones R., Kernoff L., Marks I. N. Preoperative external biliary drainage in obstructive jaundice. A prospective controlled clinical trial. Lancet. 1982 Oct 23;2(8304):896–899. doi: 10.1016/s0140-6736(82)90866-2. [DOI] [PubMed] [Google Scholar]
  7. Hermreck A. S., Thomas C. Y., 4th, Friesen S. R. Importance of pathologic staging in the surgical management of adenocarcinoma of the exocrine pancreas. Am J Surg. 1974 Jun;127(6):653–657. doi: 10.1016/0002-9610(74)90341-9. [DOI] [PubMed] [Google Scholar]
  8. Howard J. M. Pancreatico-duodenectomy: forty-one consecutive Whipple resections without an operative mortality. Ann Surg. 1968 Oct;168(4):629–640. doi: 10.1097/00000658-196810000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Höjer H. Routine systemic prophylaxis with doxycycline in elective intestinal surgery. An unrestricted prospective study. Acta Chir Scand. 1978;144(6):387–394. [PubMed] [Google Scholar]
  10. Ihse I., Lilja P., Arnesjö B., Bengmark S. Total pancreatectomy for cancer. An appraisal of 65 cases. Ann Surg. 1977 Dec;186(6):675–680. doi: 10.1097/00000658-197712000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Maki T., Sato T., Kakizaki G., Sendai Pancreatoduodenectomy for periampullary carcinomas. Appraisal of two-stage procedure. Arch Surg. 1966 Jun;92(6):825–833. doi: 10.1001/archsurg.1966.01320240013004. [DOI] [PubMed] [Google Scholar]
  12. Moossa A. R., Lewis M. H., Mackie C. R. Surgical treatment of pancreatic cancer. Mayo Clin Proc. 1979 Jul;54(7):468–474. [PubMed] [Google Scholar]
  13. Norlander A., Kalin B., Sundblad R. Effect of percutaneous transhepatic drainage upon liver function and postoperative mortality. Surg Gynecol Obstet. 1982 Aug;155(2):161–166. [PubMed] [Google Scholar]
  14. Staging of cancer of the pancreas. Cancer of the Pancreas Task Force. Cancer. 1981 Mar 15;47(6 Suppl):1631–1639. doi: 10.1002/1097-0142(19810315)47:6+<1631::aid-cncr2820471428>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  15. WARREN K. W., CATTELL R. B., BLACKBURN J. P., NORA P. F. A long-term appraisal of pancreaticoduodenal resection for peri-ampullary carcinoma. Ann Surg. 1962 May;155:653–662. doi: 10.1097/00000658-196205000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. van Heerden J. A., ReMine W. H., Weiland L. H., McIlrath D. C., Ilstrup D. M. Total pancreatectomy for ductal adenocarcinoma of the pancreas. Mayo Clinic experience. Am J Surg. 1981 Sep;142(3):308–311. doi: 10.1016/0002-9610(81)90336-6. [DOI] [PubMed] [Google Scholar]

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