[Operative results in cancer of the pancreas, especially complicated with large vascular involvement].

Surgical treatment has been performed in 25 cases of cancer of the pancreas. Localized large vascular involvements of portal vein, celiac axis, common hepatic artery and/or superior mesenteric artery by the pancreatic cancer were observed in 11 cases, which necessitated total or subtotal pancreatectomy associated with segmental resection of the vessels with vascular reconstruction in 7 cases but in remaining 4 cases resectional procedure was not performed. Curative pancreaticoduodenectomy was carried out in 5 cases without large vascular involvement and non-curative pancreatectomy in one case. Exploratory laparotomy or only anastomosis for the bile duct or the intestine was done in 8 cases. The operative resectability rate was 52% and the curative one was 44%. The regional pancreatectomy seemed to contribute to improvement of resectability. However, one year survival rate was only 42% (2 year, 0%) in the curatively resected cases with large vascular involvement, while 5 year survival rate was 67% in those without vascular involvement. The quality of life after extended total pancreatectomy was distressful. On the other hand, two extended totally pancreatectomized cases with successful autotransplantation of distal pancreas are living at one year and 3 months after operation respectively, and enjoying the common social life at present.