[Pancreatic ductal carcinoma. Intra- and postoperative complications in palliative and curative interventions]

During 1982 and 1989 we treated 95 patients with ductal pancreatic carcinoma. Of these, 32.6% (31/95) had resection. The operation lethality was 3% (1/31), the clinical lethality 12% (4/31). The median length of survival was 6,8 months. Almost half of the potential curatively operated patients showed complications. Remarkable, that patients, operated in stages III and IV have been involved over proportionally often. Complications are the intra- and postoperative bleeding, the pancreatic fistulae, the intra-abdominal abscess, the sepsis and cardiopulmonary insufficiencies. 33 Patients underwent palliative operation, where the complication rate was significantly lower. Indeed, 5 patients who got a biliodigestive anastomosis, subsequently developed a pyloric or duodenal stenosis and had to be reoperated. The 30-day-lethality of the palliatively operated patients was 13% (4/33), the clinical lethality was 15% (5/33) and the median length of survival was 5,6 months. 24 patients underwent exploratory laparotomy and 7 patients were inoperable. Due to the higher complication rate in the curatively operated patients and only little higher life expectancy, an extensive surgical treatment of pancreatic carcinoma should only be considered effective in selected cases and in an early stage of carcinoma.