Skip to main content
SpringerLink
Log in

Aspects of Radical Surgery for Exocrine Cancer of the Pancreatic Head

  • Chapter
Pancreatic Disease

  • 82 Accesses

Abstract

Although almost exactly a century has elapsed since Alessandro Codivilla performed the first pancreaticoduodenectomy in Bologna in 1898 [1], and it has been only 16 years less since Walter Kausch succeeded with a partial pancreaticoduodenectomy in Germany 1912 [2], this remains a most complex operation that carries a substantial operative risk and limited long-term success. In 1942, A. O. Whipple stated that “Many more cases with 5-year survival will be required before valid claims can be made for the operation (i.e., pancreaticoduodenectomy) as done at present. But, it must be remembered that those patients untreated have an average risk of 6 months’ survival from onset of symptoms until death... The considerable risk of 30%-35% is justified if they can be made comfortable for even a year or two” [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Codivilla A (1898) Rendiconto statistico della sezione chirurgica dell’Ospedala di Imola. (Bologna, Italy)

    Google Scholar 

  2. Kausch W (1912) Das Carcinoma der Papilla Duodeni und seine radikale Entfernung. Beitr Klin Chir 78:439–486

    Google Scholar 

  3. Cheever D (1942) Presentation of the (Bigelow) medal. N Engl J Med 226:514–515

    Article  Google Scholar 

  4. Peters JH, Carey LC (1991) Historical review of pancreaticoduodenectomy. Am J Surg 161:219–225

    Article  PubMed  CAS  Google Scholar 

  5. Gudjonsson B (1995) Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J Am Coll Surg 181:483–503

    PubMed  CAS  Google Scholar 

  6. Gudjonsson B (1996) Pancreatic cancer. The need for critical reassessment (editorial). J Clin Gastroenterol 23:2–6

    Article  PubMed  CAS  Google Scholar 

  7. Reber HA, Gloor B (1998) Radical pancreatectomy. Surg Oncol Clin N Am 7:157–163

    PubMed  CAS  Google Scholar 

  8. Trede M (1985) The surgical treatment of pancreatic carcinoma. Surgery 97:28–35

    PubMed  CAS  Google Scholar 

  9. Connolly MM, Dawson PJ, Michaelassi F, Moossa AR, Lowenstein F (1987) Survival in 1001 patients with carcinoma of the pancreas. Ann Surg 122:827–829

    Google Scholar 

  10. Andrén-Sandberg Å, Ihse I (1997) Pattern of recurrence after pancreaticoduodenectomy for exocrine pancreatic cancer: correlation with survival. In: Hanyu F, Takasaki K (eds) Pancreatoduodenectomy. Springer, Tokyo, pp 417–423

    Google Scholar 

  11. Carter CR, Imrie CW (1998) Is histological diagnosis essential before resection of suspected pancreatic carcinoma? In: Johnson CD, Imrie CW (eds) Pancreatic disease. Towards the year 2000, 2nd edn. Springer, London, pp 377–384

    Google Scholar 

  12. Barnes SA, Lillemoe KD, Kaufman HS, Sauter PK, Yeo CJ, Talamini MA, Pitt HA, Cameron JL (1996) Pancreaticoduodenectomy for benign disease. Am J Surg 171:131–135

    Article  Google Scholar 

  13. Trede M, Schwall G (1988) The complications of pancreatectomy. Ann Surg 207:39–47

    Article  PubMed  CAS  Google Scholar 

  14. Hanyu F (1997) One thousand pancreatoduodenectomies at a single institution. In: Hanyu F, Takasaki K (eds) Pancreaticoduodenectomy. Springer, Tokyo, pp 13–21

    Google Scholar 

  15. Owyang C (1998) Pancreas (editorial overview). Curr Opin Gastroenterol 14:359–361

    Article  Google Scholar 

  16. Cameron JL, Pitt HA, Yeo CJ, Lillemoe KD, Kaufman HS, Coleman J (1987) One hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann Surg 217:430–438

    Article  Google Scholar 

  17. Crist DW, Sitzman JV, Cameron JL (1987) Improved hospital morbidity, mortality and survival after the Whipple procedure. Ann Surg 206:358–365

    Article  PubMed  CAS  Google Scholar 

  18. Ihse I, Andersson H, Andrén-Sandberg Å (1996) Total pancreatectomy for cancer of the pancreas: is it appropriate? World J Surg 20:288–294

    Article  PubMed  CAS  Google Scholar 

  19. Friess H, Uhl W, Beger HG, Büchler MW (1994) Surgical treatment of pancreatic cancer. Dig Surg 11:378–386

    Article  Google Scholar 

  20. Kayahara M, Nagakawa T, Ueno K, Otha T, Takeda T, Miyazaki I (1993) An evaluation of radical resection for pancreatic cancer based on the mode of recurrence as determined by autopsy and diagnostic imaging. Cancer 72:2118–2123

    Article  PubMed  CAS  Google Scholar 

  21. Nagai H, Kuroda A, Morioka Y (1986) Lymphatic and local spread of T1 and T2 pancreatic cancer. Ann Surg 204:65–71

    Article  PubMed  CAS  Google Scholar 

  22. Ozaki H (1992) Improvement of pancreatic cancer treatment. Int J Pancreatol 12:5–9

    PubMed  CAS  Google Scholar 

  23. Kayahara M, Nagakawa T, Konishi I, et al (1991) Clinicopathological study of pancreatic carcinoma with particular reference to the invasion of the extrapancreatic neural plexus. Int J Pancreatol 10:105–111

    PubMed  CAS  Google Scholar 

  24. Hanyu F, Suzuki, Imaizumi T (1993) Whipple operation for pancreatic carcinoma: Japanese experience. In: Beger HG, Büchler MW, Malfertheiner P (eds) Standards in pancreatic surgery. Springer, Berlin Heidelberg New York, pp 654–662

    Google Scholar 

  25. Manabe T, Suzuki T, Tobe T (1985) Evaluation of en bloc radical pancreatectomy for carcinoma of the head of the pancreas involving the adjacent vessels. Dig Surg 2:27–30

    Article  Google Scholar 

  26. Nagakawa T, Konishi I, Ueno K, Ohta T, Akiyama T, Kayahara M, Miyazaki I (1991) Surgical treatment of pancreatic cancer. The Japanese experience. Int J Pancreatol 9:135–143

    PubMed  CAS  Google Scholar 

  27. Satake K, Nishiwaki H, Yokomatsu H, Kawazoe Y, Kim K, Haku A, Umeyama K, Miyazaki I (1992) Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas. Surg Gynecol Obstet 175:259–265

    PubMed  CAS  Google Scholar 

  28. Tsuchiya R, Tsunoda T, Yamaguchi T (1990) Operation of choice for resectable carcinoma of the head of the pancreas. Int J Pancreatol 6:295–306

    PubMed  CAS  Google Scholar 

  29. Miyata M, Nakao K, Takao T, et al (1990) An appraisal of pancreatectomy for advanced cancer of the pancreas based on survival rate and postoperative physical performance. J Surg Oncol 45:33–39

    Article  PubMed  CAS  Google Scholar 

  30. Tsuchiya R, Noda T, Harada N, Miyamoto T, Tomioka T, Yamamoto K, Yamaguchi T, Izawa K, Tsunoda T, Yoshino R (1986) Collective review of small carcinomas of the pancreas. Ann Surg 203:77–81

    Article  PubMed  CAS  Google Scholar 

  31. Nakayama T, Kinoshita H, Saitsu H, Lmayama H, Okuda K, Hara M, Fukuda S, Saitoh N (1997) Surgical result of pancreatoduodenectomy for disease in pancreatic head region. In: Hanyu F, Takasaki K (eds) Pancreaticoduodenectomy. Springer, Tokyo, pp 93–106

    Google Scholar 

  32. Traverso LW, Longmire WP (1978) Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynecol Obstet 146:959–962

    PubMed  CAS  Google Scholar 

  33. Traverso LW, Longmire WP (1980) Preservation of the pylorus in pancreaticoduodenectomy. A follow-up evaluation. Ann Surg 192:306–310

    Article  PubMed  CAS  Google Scholar 

  34. Newman KD, Braasch JW, Rossi RL, Campo-Gonzales S (1983) Pyloric and gastric preservation with pancreaticoduodenectomy. Am J Surg 145:152–156

    Article  PubMed  CAS  Google Scholar 

  35. Warshaw AL, Torchiana DL (1985) Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy. Surg Gynecol Obstet 160:1–4

    PubMed  CAS  Google Scholar 

  36. Irani KMF, Coleman RE, Meyers WC, Akwari OE (1986) Pylorus-preserving pancreaticoduodenectomy: a clinical and physiologic appraisal. Ann Surg 204:655–664

    Article  Google Scholar 

  37. Patel AG, Toyama MT, Kusske AM, Alexander P, Ashiey SW, Reber HA (1995) Pyloruspreserving Whipple resection for pancreatic cancer. Is it any better? Arch Surg 130:838–842

    PubMed  CAS  Google Scholar 

  38. Miedema BW, Sarr MG, van Heerden JA, Nagorney DM, McIllrath DC, Ilstrup D (1980) Complications following pancreaticoduodenectomy: current management. Arch Surg 127:945–950

    Google Scholar 

  39. Yeo CJ, Barry MK, Sauter PK, Sostre S, Lillemoe KD, Pitt HA, Cameron JL (1993) Erythromycin accelerates gastric emptying after pancreaticoduodenectomy. A prospective, randomized placebo-controlled trial. Ann Surg 218:229–238

    Article  PubMed  CAS  Google Scholar 

  40. Grace PA, Pitt HA, Longmire WP (1980) Pylorus-preserving pancreatoduodenectomy: an overview. Br J Surg 77:968–974

    Article  Google Scholar 

  41. Pitt HA, Grace PA (1990) Pylorus-preserving resection of the pancreas. Baillieres Clin Gastroenterol 4:917–930

    Article  PubMed  CAS  Google Scholar 

  42. Grace PA, Pitt HA, Longmire WP (1986) Pancreatoduodenectomy with pylorus preservation for adenocarcinoma of the head of the pancreas. Br J Surg 73:647–650

    Article  PubMed  CAS  Google Scholar 

  43. Brooks JR, Brooks DC, Levin DJ (1989) Total pancreatectomy for ductal cell carcinoma of the pancreas. Ann Surg 209:405–410

    Article  PubMed  CAS  Google Scholar 

  44. van Heerden JA, McIllrath DC, Ilstrup DM, et al (1988) Total pancreatectomy for ductal adenocarcinoma of the pancreas: an update. World J Surg 12:658–662

    Article  PubMed  Google Scholar 

  45. Farley DR, Schwall G, Trede M (1996) Completion pancreatectomy for surgical complications after pancreaticoduodenectomy. Br J Surg 83:176–179

    Article  PubMed  CAS  Google Scholar 

  46. Tashiro S, Uchino R, Hiraoka T, Tsuji T, Kawamoto S, Saitoh N, Yamasaki K, Miyauchi Y (1991) Surgical indication and significance of portal vein resection in biliary and pancreatic cancer. Surgery 109:481–487

    PubMed  CAS  Google Scholar 

  47. Takahashi S, Ogata Y, Tsuzuki T (1994) Combined resection of the pancreas and portal vein for pancreatic cancer. Br J Surg 81:1190–1193

    Article  PubMed  CAS  Google Scholar 

  48. Cubilla AL, Fortner J, Fitzgerald PJ (1978) Lymph node involvement in carcinoma of the pancreas area. Cancer 41:880–887

    Article  PubMed  CAS  Google Scholar 

  49. Nagakawa T, Kayahara M, Ohta T, et al (1991) Patterns of neural and plexus invasion of human pancreatic cancer and experimental cancer. Int J Pancreatol 10:112–119

    Google Scholar 

  50. Griffin JF, Smaley SR, Jewell W, et al (1990) Patterns of failure after curative resection of pancreatic carcinoma. Cancer 66:56–61

    Article  PubMed  CAS  Google Scholar 

  51. Brooks JR, Culebras JM (1976) Cancer of the papilla: palliative operation, Whipple procedure or total pancreatectomy? Am J Surg 131:516–520

    Article  PubMed  CAS  Google Scholar 

  52. Moossa AR, Scott MM, Lavelle-Jones M (1984) The place of total and extended total pancreatectomy in pancreatic cancer. World J Surg 8:895–899

    Article  PubMed  CAS  Google Scholar 

  53. Sarr MG, Behrns KE, van Heereden JA (1993) Total pancreatectomy. An objective analysis of its use in pancreatic cancer. Hepatogastroenterology 40:418–421

    PubMed  CAS  Google Scholar 

  54. Fortner JG (1973) Regional resection of cancer of the pancreas: a new surgical approach. Surgery 73:307–320

    PubMed  CAS  Google Scholar 

  55. Sindelar WF (1989) Clinical experience with regional pancreatectomy for adenocarcinoma of the pancreas. Arch Surg 124:127–132

    PubMed  CAS  Google Scholar 

  56. Fortner JG (1984) Regional pancreatectomy for cancer of the pancreas, ampulla, and other related sites. Ann Surg 199:418–425

    Article  PubMed  CAS  Google Scholar 

  57. Fortner JG, Klimstra DS, Senie RT, MacLean BJ (1996) Tumor size is the primary prognosticator for pancreatic cancer after regional pancreatectomy. Ann Surg 223:147–153

    Article  PubMed  CAS  Google Scholar 

  58. Tepper T, Nardi G, Suit H (1976) Carcinoma of the pancreas: review of MGM experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy. Cancer 37:1519–1524

    Article  PubMed  CAS  Google Scholar 

  59. Westerdahl J, Andrén-Sandberg Å, Ihse I (1993) Recurrence of exocrine pancreatic cancer — local or hepatic? Hepatogastroenterology 40:384–387

    PubMed  CAS  Google Scholar 

  60. Nagakawa T, Kurachi M, Konishi K, Miyazaki I (1982) Translateral retroperitoneal approach in radical surgery for pancreatic cancer. Jpn J Surg 12:229–233

    Article  PubMed  CAS  Google Scholar 

  61. Ishikawa O, Ohigashi H, Sasaki Y, Kabuto T, Fukoda I, Furukawa H, Imaoka S, Iwanaga T (1988) Practical usefulness of lymphatic and connective tissue clearance for carcinoma of the pancreatic head. Ann Surg 208:215–220

    Article  PubMed  CAS  Google Scholar 

  62. Gall FP, Zirngibl H (1993) Cancer of the pancreas — extended lymph node dessection. In: Beger HG, Büchler MW, Malfertheiner P (eds) Standards in pancreatic surgery. Springer, Berlin Heidelberg New York, pp 654–662

    Google Scholar 

  63. Manabe T, Baba N, Setoyama H, et al (1991) Venous bypass grafting for celiac occlusion in radical pancreaticoduodenectomy. Pancreas 6:368–371

    Article  PubMed  CAS  Google Scholar 

  64. Ishikawa O, Ohigashi H, Sasaki Y, Furukawa H, Kabuto T, Kameyama M, Nakamori S, Hiratsuka M, Imaoka S (1994) Liver perfusion chemotherapy of both the hepatic artery and portal vein to prevent hepatic metastasis after extended pancreatectomy for adenocarcinoma of the pancreas. Am J Surg 168:361–364

    Article  PubMed  CAS  Google Scholar 

  65. Lieberman MD, Kilburn H, Lindsey M, Brennan MF (1995) Relation of preoperative deaths to hospital volume among patients undergoing pancreatic resection for malignancy. Ann Surg 222:638–645

    Article  PubMed  CAS  Google Scholar 

  66. Andrén-Sandberg Å, Ihse I (1983) Factors influencing survival after total pancreatectomy in patients with pancreatic cancer. Ann Surg 198:605–610

    Article  PubMed  Google Scholar 

  67. Al-Sharaf K, Ihse I, Dawiskiba S, Andrén-Sandberg Å (1997) Characteristics of the gland remnant predict complications after subtotal pancreatectomy. Dig Surg 14:101–106

    Article  Google Scholar 

  68. Gordon TA, Bowman HM, Tielsch JM, Bass EB, Burleyson GP, Cameron JL (1998) Statewide regionalization of pancreaticoduodenectomy and its effect on in-hospital mortality. Ann Surg 228:71–78

    Article  PubMed  CAS  Google Scholar 

  69. Gordon TA, Burleyson GP, Tielsch JM, Cameron JL (1995) The effects of regionalization on cost and outcome for one general high-risk procedure. Ann Surg 221:43–49

    Article  PubMed  CAS  Google Scholar 

  70. Glasgow RE, Mulvhill SJ (1996) Relation of hospital volume to outcome in patients undergoing Whipple resections for adenocarcinoma in Northern California hospitals in 1993. Presented at the Thirtieth Annual Meeting of Pancreas Club Inc, San Fransisco, Calif., May 19

    Google Scholar 

  71. Bramhall SR, Allum WH, Jones AG, Allwood A, Cummins C, Neoptolemos JPN (1995) Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease, in the West Midlands: an epidemiological study. Br J Surg 82:111–115

    Article  PubMed  CAS  Google Scholar 

  72. Finch MD, Neoptolemos JP (1998) Pancreatic resection for pancreatic cancer: outcome in specialist units. In: Johnson CD, Imrie CW (eds) Pancreatic disease. Towards the year 2000, 2nd edn. Springer, London, pp 385–396

    Google Scholar 

  73. Trede M, Schwab M (1996) Extensive palliative carcinoma operation — is it really worthwhile? What are the aims? Langenbecks Arch Chir Suppl Kongressbd 113:89–90

    Google Scholar 

  74. Andrén-Sandberg Å, Bäckman PL, Andersson R (1997) Results of adjuvant therapy in resected pancreatic cancer. Int J Pancreatol 21:31–38

    PubMed  Google Scholar 

  75. Yeo CJ, Abrams RA, Grochow LB, Sohn TA, Ord SE, Hruban RH, Zahurak ML, Dooley WC, Coleman J, Sauther PK, et al (1997) Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience. Ann Surg 225:621–633

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Åke Andrén-Sandberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dag Hoem
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hjörtur Gislason
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Andrén-Sandberg, Å., Hoem, D., Gislason, H. (1999). Aspects of Radical Surgery for Exocrine Cancer of the Pancreatic Head. In: Pancreatic Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60068-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60068-5_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-65357-8

  • Online ISBN: 978-3-642-60068-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation