Surgical treatment of pancreatic cancer. The Swedish experience

The development at a university hospital of radical surgery for exocrine pancreatic cancer has been studied for the time period 1958-1989. It was found that the number of operations per year increased gradually, being 6.6/year during the last 5 years, giving a resection rate of 15%. The resection rate did not change during the studied time period. The size, grade of differentiation, or stage of tumor did not change. There was no significant tendency toward decreasing operation time and blood loss, although a technically more complicated operation has been done in the last 30 cases (change from total to subtotal duodenopancreatectomy). The hospital mortality rate decreased from 33 to 3%. The rate and severity of post-operative complications also strongly decreased. For the last 30 cases, there was also a prolonged long-term survival. We conclude that the total management of patients radically operated on for exocrine pancreatic cancer is today much better than it was a decade or two ago.