[Medical behaviors and cancer of the exocrine pancreas]

A French national enquiry examined 4,530 cases of cancer of the exocrine pancreas treated from 1982 to 1989. Ultrasonography was performed in 98% of cases. Other radiological or biological investigations varied from one department to another (P < 0.001). Of 769 patients seen in Gastroenterology departments, 47% (range: 0 to 72%) were operated on. Of 3,761 patients undergoing operation, surgical techniques differed significantly from one department to another (P < 0.001). Resections were performed in 21% (range: 2 to 45%) of cases. Causes of unresectability, choice of biliary bypass, indications for gastrojejunostomy, and use of splanchnicectomy varied from one surgical department to another (P < 0.01). Wide variance in therapeutic policies may be explained by differences in local indications or surgical expertise, giving support to the need for a consensus conference to discern the indications of the available therapeutic alternatives for cancer of the exocrine pancreas.