[Regional pancreatectomy in the treatment of pancreatic adenocarcinoma. Apropos of 41 cases].
Out of 88 carcinomas of the pancreas observed from 1973 through 1981, 41 regional total (19 patients) or subtotal (22 patients) pancreatectomies were performed. Routine histological examination of 12 lymph nodes areas and pancreatic peritoneal involvement were used to determine three stages: 1) stage I without metastatic lymph nodes involvement (18 patients), 2) stage II with peripancreatic metastatic lymph node involvement (14 patients), 3) stage III with pedicular and/or retroperitoneal metastatic lymph node and/or peritoneal involvement. Six patients died in the postoperative period (14.6 p. 100). Complications were infections (11 patients), pancreatic anastomotic leakage after subtotal pancreatectomy (11 patients), digestive bleeding (8 patients). No patients need insulin two months after subtotal pancreatectomy. After total pancreatectomy diabetes mellitus was controlled by 0.30 UI/kg/day of insulin (mean). The three years survival was 38 p. 100 (Kaplan-Meier). In the author's experience, regional pancreatectomy seems to be the best surgical procedure in patients with carcinoma of the pancreas except in patients with poor general condition, age over 75, and stage III.
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D013997:Time Factors
La pancréatectomie régionale dans le traitement de l'adénocarcinome du pancréas. A propos de 41 cas.