Document Detail


Surgical treatment of cancer of the pancreas and the periampullary region: cumulative results in 57 institutions in Japan.
MedLine Citation:
PMID:  831636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this study the experiences with carcinomas of the pancreas, ampulla of Vater, terminal comma bile duct, and duodenum found in a series of 3,610 patients collected from 57 major Japanese institutions was compiled over a 26 year period. The results were analyzed as to the success of resectional and palliative surgery for the various lesions. The most common lesion was carcinoma of the head of the pancreas. Unifortunately, only 18.3% of these patients were resectable with a 25.3% mortality. Carcinoma of the body and the tail was the second most frequent lesion, and it also exhibited a low resection rate. Carcinomas of the ampulla and the terminal common bile duct and duodenal regions were the most favorable for resection; usually pancreatoduodenectomy with an overall mortality of 20.8%. As a result of the large number of pancreatectomies performed, there was also a large number of postoperative complications, the most frequent being leakage at an anastomotic line. Hemorrhage also occurred frequently. Distal pancreatectomies were reserved for carcinoma of the body and the tail of the pancreas, and the most common postoperative complication of this procedure was hemorrhage. There were only 45 total pancreatectomies among the 973 resections being performed most frequently in patients with carcinoma of the head of the pancreas. Again, the most frequent postoperative complication was hemorrhage, followed by anastomotic leakage. The long term survivals following resection for these lesions were each poor. The best mean survival time was 22.7 months for carcinoma of the ampulla of Vater. Patients having resections for carcinoma of the head of the pancreas had a mean survival time of 12.3 months. At 5 years there were few survivors and most of them were patients who had undergone resections for carcinoma of the ampulla of Vater.
Authors:
A Nakase; Y Matsumoto; K Uchida; I Honjo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  185     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1977 Jan 
Date Detail:
Created Date:  1977-02-26     Completed Date:  1977-02-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  52-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Ampulla of Vater / surgery*
Bile Duct Neoplasms / mortality,  surgery*
Carcinoma / surgery
Duodenal Neoplasms / mortality,  surgery*
Duodenum / surgery
Hemorrhage / complications
Humans
Japan
Pancreatectomy / mortality
Pancreatic Neoplasms / mortality,  surgery*
Postoperative Complications
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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