title: [Surgical treatment of pancreatic and periampullary carcinoma in a specialized unit: a decade later].
abstract: BACKGROUND
  Results of surgical treatment for pancreatic and periampullary carcinoma have improved in recent years owing to several factors, particularly the concentration of these patients in specialised surgical units.
  
  
  METHODS
  Retrospective-prospective comparative study of results in 2 groups of patients treated over 2 different periods of time and with different surgical policy: group A, which included 80 patients treated from 1982 to 1992 in a general surgery unit, and group B, which comprised 151 patients treated from 1998 to 2003 in a specialised hepato-biliary-pancreatic surgery unit.
  
  
  RESULTS
  Surgical treatment in patients of groups A and B, respectively, was: resection in 20% and 53.6% and by-pass in 62.5% and 36.4%. Postoperative morbidity after resection was similar (75% vs 74.1%) but higher after by-pass in group B (41.8% vs 34%). Postoperative mortality after surgical resection and by-pass was 25% and 14.1%, respectively, for group A and 3.7% and 16.3%, respectively, for group B. Mean survival for all patients was 7.0 +/- 7.1 months for group A and 14.1 +/- 15.3 months for group B. Mean survival for patients with surgical resection was 11.8 +/- 9.8 months and 18.7 +/- 15.8 months for groups A and B, respectively.
  
  
  CONCLUSIONS
  Pancreatic and periampullary carcinoma should be surgically treated in specialised pancreatic surgery units in order to offer the best outcome to patients.
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Balsells-Valls
authors.forename: J J
authors.initials: JJ
authors.lastname: Olsina-Kissler
authors.forename: I
authors.initials: I
authors.lastname: Bilbao-Aguirre
authors.forename: A
authors.initials: A
authors.lastname: Solans-Doménech
authors.forename: C
authors.initials: C
authors.lastname: Margarit-Creixell
authors.forename: M
authors.initials: M
authors.lastname: Armengol-Carrasco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016019:Survival Analysis