Operative mortality following surgery for carcinoma of the pancreas.

A series of 85 patients with carcinoma of the pancreas seen in South India has been analysed. The median age was 50 years, 20% of patients being below years of age, and the male to female ratio was 4:1. Diabetes mellitus and smoking were more prevalent among males than in a control group, but this was not the case with alcoholism. Distribution of blood groups was the same as in controls. Clinical features of these patients are reviewed. Operative mortality in jaundiced patients was similar whether simple laparotomy, a biliary bypass procedure or a pancreaticoduodectomy was done. This mortality was related to the depth of jaundice and to the degree of abnormality in serum transaminase levels, but it was not related to the age of the patient, the stage of the disease, ECG evidence of ischaemic heart disease, or abnormalities in either serum albumin concentration or blood urea level. Following biliary bypass procedures 50% of patients were dead within eight months; after pancreatoduodenectomy this interval was increased to 18 months, but differences in the stage of the disease between the two groups would account for the difference in survival to some extent.