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KMID : 0870419980020020123
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998 Volume.2 No. 2 p.123 ~ p.127
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Validity of Resection in Pancreas Cancer
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Heo Jin-Seok
Choi Seong-Ho
Sohn Tae-Sung
Cho Jae-Won
Kim Byung-Soo
Kim Yong-Il
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Abstract
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Background/Aims: Surgical resection is the only chance for long-term survival in pancreas exocrine cancer patients. However, most surgeons remain hesitant to perform pancreaticoduodenectomy unless surgical margins are widely clear, choosing instead to perform palliative biliary and gastric bypass. However, pancreaticoduodenectomy is now a remarkably safe operation with near zero mortality and verb low morbidity. As a result we have taken a tier aggressive approach to pancreas cancer and we retrospectively studied the results of 40 pancreatic resections for cancer of the exocrine pancreas and compared the different types of procedures.
Methods: Sixty patients had histologically-proven adenocarcinoma of the pancreas and were operated on from May 1995 to November 1997. Forty underwent surgical resection and 20 had a palliative procedures. We retrospectively analysed the stages, surgical procedures, mortality, morbidity and long-term survival.
Results: The overall postoperative mortality rate was 2.5%. After resection and bypass, the median survival times were 12.0 months and 10.0months, respectively (p=0.1630). Patients resected with a negative margln (R0 group) had median survival of 13.7 months, whereas the R1 group 12.1 months, and the R2 group was 7.9 months (0.0737). The median survival time after resection of the portal vein or SMV was 8 months, while after pancreas resection without portal vein resection it was 12 months. There was no significant difference(p=0.0812).
Conclusion: Surgical resection can be performed with a similar perioperative mortality and morbidity compared with bypass surgery it should be considered as the best palliative procedure for this disease.
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KEYWORD
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Pancreatic neoplasm, Pancreas, Pancreatectomy, Surgery, Pancreaticoduodenectomy
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