title: Subtotal duodeno-pancreatectomy for carcinoma of the head of the pancreas. Preliminary report of an alternative operation to total pancreatectomy.
abstract: For ductal carcinoma of the head of the pancreas and large periampullary carcinoma with wide infiltration into the head of the pancreas a subtotal duodeno-pancreatectomy with preservation of the pancreatic tail and spleen is introduced as an alternative to total pancreatectomy. A preliminary report of 38 operations shows a mortality of only 3% and a low morbidity. Diabetes mellitus increased from 17% preoperatively to 40% postoperatively, therefore, in 60% a normal carbohydrate metabolism was preserved. At present 5 of 20 patients (R0) with ductal cancer are alive and free of recurrence 18 to 55 months after the operation with a median survival of 12 months for all curatively resected patients. No negative influence on median survival time can yet be recognized. Subtotal duodeno-pancreatectomy was performed with a much lower operative risk than total pancreatectomy and seems to be as effective as total organ removal.
authors.affiliation: Department of Surgery, University Erlangen, F.R.G.
authors.forename: F P
authors.initials: FP
authors.lastname: Gall
mesh_terms: D000328:Adult; D000368:Aged; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications