Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients

摘要: OBJECTIVE: This single-institution study examined the outcome after pancreaticoduodenectomy in patients with adenocarcinoma of head pancreas. SUMMARY OF BACKGROUND DATA: In recent years, for pancreas has been associated decreased morbidity and mortality and, some centers, 5-year survival rates excess 20%. METHODS: Two hundred one pathologically verified undergoing at The Johns Hopkins Hospital between 1970 1994 were analyzed (the last 100 resections performed March 1991 April 1994). is largest experience reported to date. RESULTS: overall postoperative in-hospital rate was 5%, but 0.7% 149 patients. actuarial all 201 21%, a median 15.5 months. There 11 survivors. Patients resected negative margins (curative resections: n = 143) had an 26%, 18 months, whereas those positive (palliative resections; 58) fared significantly worse, 8% 10 months (p < 0.0001). Survival improved from decade 0.002), 3-year 14% 1970s, 21% 1980s, 36% 1990s. Factors favoring long-term by univariate analyses included tumor diameter 3 cm, nodal status, diploid DNA content, S phase fraction 18%, pylorus-preserving resection, 800 mL intraoperative blood loss, 2 units transfused, resection margins, use adjuvant chemotherapy radiation therapy. Multivariate indicated strongest predictors resection. CONCLUSIONS: pancreatic treated improving. Aspects biology, such as diameter, status margin are outcome.