Abstract
AbstractThe results of surgical treatment of pancreatic exocrine cancer are poor. There exists a definite small group of patients with early cancers in the head of the pancreas that are potentially curable. It is generally agreed that prolonged survival is obtained only with resection as opposed to a palliative bypass procedure. The only real controversy that remains concerns the extent of the resection. The 3 options available to the surgeon are Whipple pancreatoduodenectomy, total pancreatectomy, and the more radical regional pancreatectomy. Our opinion, based on previous experience, is that total pancreatectomy is the operation of choice for cancer in the head of the pancreas. This operation excludes many of the risk factors associated with the Whipple operation, with no evidence of increased morbidity or mortality. We feel that the case for extended total pancreatectomy is tenuous and yet to be proven, and that there is little or no place for this operation.
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