[Specific features of pancreatoduodenal resection in cancer of the head and unciform process of the pancreas].

Pancreato-duodenal resections (PDR) were made in 134 patients with cancer of the pancreas, in 31 (23.1%) of them the tumor was localized in the unciform process of the pancreas. In 7 patients the destructive pancreatitis which complicated cancer PDR was completed by the external drainage of the pancreatic duct. Combined PDR were fulfilled in 14 (10.4%) patients including 9 (29.0%) of 31 patients who had cancer of the unciform process. In 48 (35.8%) patients PDR was followed by complications. The most frequent of them were acute pancreatitis of the stump (32.1%) and incompetent pancreatoenteroanastomosis (18.7%). Postoperative lethality after PDR was 6.7%. During the recent six years no lethal outcomes have been observed after 45 PDR. Cancer of the uniform process of the pancreas is the least favorable localization. Combined PDR are followed by a great number of intraoperative, postoperative complications and high lethality rate. If the patients had mechanical jaundice, the use of double step PDR gave better results. If there were intraoperative signs of acute pancreatitis it was necessary to drain the pancreatic duct outside. The using of intraoperative occlusions of the pancreatic ducts is hardly justified because of a high risk of the development of acute pancreatitis.