[Proximal duodenopancreatectomy in the treatment of tumors of the bilio-pancreatic junction].

Between 1978 and 1983, 32 patients underwent a proximal duodeno-pancreatectomy for malignant lesions of the ampullary region on head on the pancreas. Pre-operative diagnosis was made by endoscopic cholangio-pancreatography, echography, tomodensitometry and arteriography. 14 patients underwent a pre-operative endoscopic bile drainage procedure. The operative mortality was 6,2% and the morbidity 43%; the intensity of the icterus as well as the preoperative bile drainage procedure did not change these factors significantly. The pre-operative diagnostic procedures permitted a clear definition of the extent of the tumor and retrospective analysis demonstrated their prognostic significance with regard to long-term survival. 11 patients are still alive. The presence of histologically proven metastases reduce significantly the duration of survival. Surgical resection is the best treatment for malignant tumors of the ampullary region and the head of the pancreas without local or distant metastases.