Swope T J, Wade T P, Neuberger T J, Virgo K S, Johnson F E
Department of Surgery, John Cochran Department of Veterans Affairs Medical Center, St. Louis, Missouri.
Am J Surg. 1994 Dec;168(6):582-5; discussion 585-6. doi: 10.1016/s0002-9610(05)80126-6.
After enthusiasm for total pancreatectomy for pancreatic adenocarcinoma peaked in the 1970s, a failure to improve outcomes in the 1980s led to fewer reports of this procedure.
We retrieved records from 252 Whipple and 47 total pancreatectomies for pancreatic cancer performed at U.S. Department of Veterans Affairs hospitals from 1987 to 1991.
Thirty-day mortality was 8% with both procedures. There was no significant difference in morbidity at 30 days (Whipple 36%, total pancreatectomy 39%). The mean survival after total pancreatectomy was 526 days compared to 376 days following Whipple (P = 0.03). Staging information was retrieved from tumor registrars for 117 patients with pancreatic adenocarcinoma, 21 of whom underwent total pancreatectomy and 96 the Whipple procedure. In patients with stage I and stage II localized pancreatic adenocarcinoma, mean survival was 772 days in 11 patients after total pancreatectomy, and 446 days in 55 patients after Whipple resection (P = 0.057).
The type of resection did not affect the mean survival of patients with stage III (nodal metastases) or stage IV (distant metastases) cancer.
20世纪70年代，胰腺腺癌全胰切除术的热情达到顶峰，而20世纪80年代未能改善治疗结果导致该手术的报告减少。
我们检索了1987年至1991年在美国退伍军人事务部医院进行的252例胰十二指肠切除术和47例胰腺癌全胰切除术的记录。
两种手术的30天死亡率均为8%。30天时的发病率无显著差异（胰十二指肠切除术为36%，全胰切除术为39%）。全胰切除术后的平均生存期为526天，而胰十二指肠切除术后为376天（P = 0.03）。从肿瘤登记处获取了117例胰腺腺癌患者的分期信息，其中21例行全胰切除术，96例行胰十二指肠切除术。在I期和II期局限性胰腺腺癌患者中，11例全胰切除术后的平均生存期为772天，55例胰十二指肠切除术后为446天（P = 0.057）。
手术切除方式不影响III期（淋巴结转移）或IV期（远处转移）癌症患者的平均生存期。
