[The surgical possibilities in patients with adenocarcinoma of the pancreas].

OBJECTIVE

To analyze the types of surgical procedures which can be performed in patients with pancreatic adenocarcinoma and its results.

SUMMARY BACKGROUND DATA

Until the 80's the incidence of resection for pancreatic adenocarcinoma was low with a high morbidity and mortality rates, and the 5-year survival rate below 8 per cent. During the last decade many reports in the international literature are showing very low morbidity and mortality rates and much better long-term survival rates (35-40 per cent). The palliative procedures had not change.

METHODS

The retrospective analysis of charts of patients with any surgical procedures and diagnosis of pancreatic adenocarcinoma, between 1962 and 1991, was performed, such analysis included demographic data, surgical procedures, operative morbidity and mortality, and long-term results.

RESULTS

There were 410 patients, 52 per cent were males and 48 per cent were females. Tumor resection was possible in only 20 per cent of the patients (pancreatoduodenectomy 69 per cent, distal pancreatectomy 17 per cent and total pancreatectomy 14 per cent). The remaining 80 per cent were candidates for palliative procedures (73 per cent) and diagnostic procedures (27 per cent). The resected group showed a high operative morbidity and mortality rates in particular total pancreatectomy, and the 5-year survival rate was 8 per cent. This figure was 4 per cent with the Whipple's procedure. When palliative or diagnostic procedures were performed, 97 per cent were dead during the first 12 months, and there were no survivors after 20 months.

CONCLUSIONS

Our results are equal to those reported in the world literature until 1985, after that date better results are increasingly reported, but we shall wait at least the next decade in order to know if there are some changes in our results. There has been no changes with palliative procedures.