title: [Therapeutic strategy in carcinoma of the exocrine pancreas].
abstract: A series of 311 consecutive patients undergone surgery for pancreatic carcinoma in the Department of General Surgery from July 1979 to March 2003. We performed 41 standard pancreaticoduodenal resections (13%: 30 DCP, 2 total pancreatectomies, 9 splenopancreatectomies), 235 by-passes (75.5%: 114 Roux-en-Y hepaticojejunostomies, 99 hepaticojejunostomies with GEA, 22 GEA), 35 explorations and biopsy (11.2%: 28 LE and 7 VLS). Mortality rate was: 2.4% in Resection, 3.7% in BB(+)-GEA, 18.8% in GEA, 0% in LE-VLS. Morbidity rate was: 43.9% in resection (pancreatic fistula 21.9, haemorrhage 12.1, pneumonia 4.8, infection and delayed gastric emptying 2.4), 10.3% in BB(+)-GEA, 27% in GEA, 5.7% in LE. Actual survival rate was at 3 and 5 years after resection 9.7% and 4.8% respectively with median 18 months; mean survival was after by-pass 11 months (min 3, max 38) with median 9 months.
authors.affiliation: Reparto di Chirurgia Generale Ospedale SS Trinità, AUSL 8, Cagliari.
authors.forename: A
authors.initials: A
authors.lastname: Puliga
authors.forename: R
authors.initials: R
authors.lastname: Sulis
authors.forename: A
authors.initials: A
authors.lastname: Tocco
authors.forename: R
authors.initials: R
authors.lastname: Hellies
authors.forename: M
authors.initials: M
authors.lastname: Pietrangeli
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D005260:Female; D005763:Gastroenterostomy; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013156:Splenectomy; D015996:Survival Rate