Whipple's operation for carcinoma of the pancreatic head and the ampullary region. Short-and long-term results

• Published in: Scandinavian journal of gastroenterology Vol. 33; no. 7; p. 759
• Main Authors: Sørensen, M B, Lundemose, J B, Rokkjaer, M, Jacobsen, N O
• Format: Journal Article
• Language: English
• Published: England 1998
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Ampulla of Vater - pathology; Ampulla of Vater - surgery; Biopsy; Disease-Free Survival; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Pancreas - pathology; Pancreas - surgery; Pancreatectomy - adverse effects; Pancreatectomy - methods; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - surgery; Prognosis; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome
• ISSN: 0036-5521
• DOI: 10.1080/00365529850171729

In this retrospective review short- and long-term perspectives have been evaluated for 108 patients who, during 1982 through 1992, had Whipple's operation performed for carcinoma of the pancreatic head (PC, n=63) or the ampullary region (AC, n=45). In 24 patients the operation was not radical (21 with PC and 3 with AC). Total perioperative morbidity was 60%, and 13 patients (12%) died within 30 days of operation. This decreased from 15.2% in the first half of the study period to 8.2% in the second half. Recurrence occurred in 56.2% of the remaining 73 patients, with no significant differences between PC and AC. Recurrence was related to regional lymph node metastases and poor tumour differentiation. Overall 5-year survival was 7.4% for PC and 24.8% for AC. For patients with radically excised tumours surviving 30 days the 5-year survival rates were 13.1% for PC and 30% for AC. Careful preoperative evaluation is still of great importance.