[Treatment of cancer of the pancreas (biliary-digestive bypass or excision?). Retrospective study of 164 patients].

The aim of this work was to study retrospectively the survival of 164 patients with cancer of the pancreas diagnosed in a gastroenterological unit from 1975 to 1984, according to the therapeutic procedure: 50 patients have not been operated, 12 have undergone an exploratory laparotomy, 72 patients a biliary bypass, 13 patients had undergone a pancreato-duodenectomy, 15 patients a total pancreatectomy, and 2 a caudal pancreatectomy; 9 patients inoperable had benefit from endoscopic biliary drainage. The survival was not statistically different in the 4 groups of patients. Today with a 2 year's follow-up, all patients have died. In the homogeneous group of 80 patients having a tumor of the head of the pancreas, the survival of the unoperated patients (72 +/- 19 days) is statistically lower than that of the patients having a biliary by-pass (187 +/- 28 days) (p less than 0.02). According to the Cox model, the variables age, sex, tumor localization and diagnosis delay did not influence the survival time. In conclusion, the results of this study confirm the severity of the cancer of the pancreas, whatever the therapeutic procedure used. Because of lack of controlled studies, it is impossible to codify the therapeutic procedure of cancer of pancreas.