Cancer of the head of the pancreas: an institutional review with emphasis on surgical therapy.

A clinical review of 461 patients with adenocarcinoma of the pancreas is presented. Seventy-nine percent of the group underwent laparotomy, including laparotomy and biopsy (n = 134), bypass procedures (n = 207), and radical resection (n = 24). The operative mortality following cholecystoenterostomy or choledochoenterostomy was similar but survival was greater following the latter procedure. Thirteen percent having biliary bypass alone needed later gastric bypass. Radical resection is recommended under favorable conditions (6.6% in this series). The five-year survival in this group was 12.5% and the operative mortality was 9% over the last 10 years.