Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1977 Jan;185(1):52–57. doi: 10.1097/00000658-197701000-00008

Surgical treatment of cancer of the pancreas and the periampullary region: cumulative results in 57 institutions in Japan.

A Nakase, Y Matsumoto, K Uchida, I Honjo
PMCID: PMC1396263  PMID: 831636

Abstract

In this study the experiences with carcinomas of the pancreas, ampulla of Vater, terminal comma bile duct, and duodenum found in a series of 3,610 patients collected from 57 major Japanese institutions was compiled over a 26 year period. The results were analyzed as to the success of resectional and palliative surgery for the various lesions. The most common lesion was carcinoma of the head of the pancreas. Unifortunately, only 18.3% of these patients were resectable with a 25.3% mortality. Carcinoma of the body and the tail was the second most frequent lesion, and it also exhibited a low resection rate. Carcinomas of the ampulla and the terminal common bile duct and duodenal regions were the most favorable for resection; usually pancreatoduodenectomy with an overall mortality of 20.8%. As a result of the large number of pancreatectomies performed, there was also a large number of postoperative complications, the most frequent being leakage at an anastomotic line. Hemorrhage also occurred frequently. Distal pancreatectomies were reserved for carcinoma of the body and the tail of the pancreas, and the most common postoperative complication of this procedure was hemorrhage. There were only 45 total pancreatectomies among the 973 resections being performed most frequently in patients with carcinoma of the head of the pancreas. Again, the most frequent postoperative complication was hemorrhage, followed by anastomotic leakage. The long term survivals following resection for these lesions were each poor. The best mean survival time was 22.7 months for carcinoma of the ampulla of Vater. Patients having resections for carcinoma of the head of the pancreas had a mean survival time of 12.3 months. At 5 years there were few survivors and most of them were patients who had undergone resections for carcinoma of the ampulla of Vater.

Full text

PDF
52

Selected References

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

  1. Aston S. J., Longmire W. P., Jr Management of the pancreas after pancreaticoduodenectomy. Ann Surg. 1974 Mar;179(3):322–327. doi: 10.1097/00000658-197403000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BUCKWALTER J. A., LAWTON R. L., TIDRICK R. T. BYPASS OPERATIONS FOR NEOPLASTIC BILIARY TRACT OBSTRUCTION. Am J Surg. 1965 Jan;109:100–106. doi: 10.1016/s0002-9610(65)80110-6. [DOI] [PubMed] [Google Scholar]
  3. Crile G., Jr The advantages of bypass operations over radical pancreatoduodenectomy in the treatment of pancreatic carcinoma. Surg Gynecol Obstet. 1970 Jun;130(6):1049–1053. [PubMed] [Google Scholar]
  4. Feduska N. J., Dent T. L., Lindenauer S. M. Results of palliative operations for carcinoma of the pancreas. Arch Surg. 1971 Aug;103(2):330–334. doi: 10.1001/archsurg.1971.01350080246039. [DOI] [PubMed] [Google Scholar]
  5. GLENN F., THORBJARNARSON B. CARCINOMA OF THE PANCREAS. Ann Surg. 1964 Jun;159:945–958. doi: 10.1097/00000658-196406000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Goldsmith H. S., Ghosh B. C., Huvos A. G. Ligation versus implantation of the pancreatic duct after pancreaticoduodenectomy. Surg Gynecol Obstet. 1971 Jan;132(1):87–92. [PubMed] [Google Scholar]
  7. HONJO I. Total pancreatectomy. J Int Coll Surg. 1956 May;25(5):551–557. [PubMed] [Google Scholar]
  8. Pope N. A., Fish J. C. Palliative surgery for carcinoma of the pancreas. Am J Surg. 1971 Mar;121(3):271–272. doi: 10.1016/0002-9610(71)90203-0. [DOI] [PubMed] [Google Scholar]
  9. Sato T., Saitoh Y., Koyama K., Watanabe K. Preoperative determination of operability in carcinomas of the pancreas and the periampullary region. Ann Surg. 1968 Nov;168(5):876–886. doi: 10.1097/00000658-196811000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Smith P. E., Krementz E. T., Reed R. J., Bufkin W. J. An analysis of 600 patients with carcinoma of the pancreas. Surg Gynecol Obstet. 1967 Jun;124(6):1288–1290. [PubMed] [Google Scholar]
  11. Smith R. Progress in the surgical treatment of pancreatic disease. Am J Surg. 1973 Feb;125(2):143–153. doi: 10.1016/0002-9610(73)90019-6. [DOI] [PubMed] [Google Scholar]
  12. Suzuki T., Kuratsuka H., Uchida K., Matsumoto Y., Honjo I. Carcinoma of the pancreas arising in the region of the uncinate process. Cancer. 1972 Sep;30(3):796–800. doi: 10.1002/1097-0142(197209)30:3<796::aid-cncr2820300330>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. Warren K. W., Braasch J. W., Thum C. W. Carcinoma of the pancreas. Surg Clin North Am. 1968 Jun;48(3):601–618. doi: 10.1016/s0039-6109(16)38543-7. [DOI] [PubMed] [Google Scholar]
  15. Whipple A. O., Parsons W. B., Mullins C. R. TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER. Ann Surg. 1935 Oct;102(4):763–779. doi: 10.1097/00000658-193510000-00023. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES