title: Pancreatic carcinoma: surgical treatment.
abstract: There is controversy in the literature over the surgical treatment of pancreatic carcinoma, especially whether gastro-enterostomy should be performed prophylactically when palliative biliary bypass is done. The authors report a retrospective study of 184 patients with pancreatic carcinoma treated at the Hôtel-Dieu Hospital in Montreal between 1970 and 1982. Of these, 106 patients had cancer of the head of the pancreas. In this group, 15 had a Whipple procedure. Median survival was 512 days with no 5-year survivors. Forty-nine patients had biliary bypass alone and 3 needed gastroenterostomy later for duodenal obstruction. Eleven patients had both biliary--enteric bypass and gastroenterostomy. Biliary bypass using the common duct gives the same result as that using the gallbladder. Considering their reoperation rate of only 7.3%, the authors do not believe that prophylactic gastroenterostomy is indicated in these patients.
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000601:surgery; D004380:Duodenal Obstruction / Q000601:surgery; D005260:Female; D005763:Gastroenterostomy; D006801:Humans; D007565:Jaundice / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D013156:Splenectomy