Parker G A, Postlethwait R W
J Surg Oncol. 1985 Jan;28(1):36-8. doi: 10.1002/jso.2930280110.
The courses of 208 patients with adenocarcinoma of the pancreas were reviewed. The lesion was located in the head of the pancreas in 142 patient, (68%) and of these, in 22 patients the diagnosis was confirmed histologically at postmortem examination; 21 patients underwent laparotomy and biopsy with a 33% operative mortality and a 3.4-month average survival; 89 patients underwent biliary and/or gastric bypass with a 24% mortality and 4.8-month average survival; 10 patients underwent pancreaticoduodenectomy with a 20% mortality and 14.6-month average survival. The lesion was located in the body or tail of the pancreas in 77 patients (32%); and, of these, 15 patients had histologic confirmation of clinical diagnoses at postmortem examination; 19 patients underwent biopsy of extra-abdominal metastases and survived an average of 1.4 months; 27 patients underwent laparotomy and biopsy with a 26% operative mortality and 3.5-month average survival; 4 patients underwent gastric and/or biliary bypass with a 50% mortality and 4.5-month average survival; one patient underwent noncurative distal pancreatectomy and survived 1 month postoperatively. No patient was cured of his disease. Of the 55 operative survivors of biliary bypass alone for carcinoma of the head of the pancreas, 5 (9%) required subsequent gastroenterostomy for duodenal obstruction.
对208例胰腺癌患者的病程进行了回顾。142例（68%）患者的病变位于胰头，其中22例在尸检时经组织学确诊；21例患者接受了剖腹探查和活检，手术死亡率为33%，平均生存期为3.4个月；89例患者接受了胆管和/或胃旁路手术，死亡率为24%，平均生存期为4.8个月；10例患者接受了胰十二指肠切除术，死亡率为20%，平均生存期为14.6个月。77例（32%）患者的病变位于胰体或胰尾；其中15例在尸检时经组织学证实临床诊断；19例患者接受了腹部外转移灶活检，平均存活1.4个月；27例患者接受了剖腹探查和活检，手术死亡率为26%，平均生存期为3.5个月；4例患者接受了胃和/或胆管旁路手术，死亡率为50%，平均生存期为4.5个月；1例患者接受了非根治性远端胰腺切除术，术后存活1个月。无一例患者治愈。仅因胰头癌行胆管旁路手术的55例手术存活者中，5例（9%）因十二指肠梗阻需要后续行胃肠吻合术。
