[Management of exocrin pancreatic tumor. About 129 cases]

Management of exocrine pancreatic tumors is very difficult: Their impact is in upsurge and their diagnosis is very often made to an advanced stage that only allows the therapeutic palliative. To value the management of these tumors to the surgical clinic of Aristide Le Dantec hospital, authors achieved a retrospective survey on 8years (October 1994 to October 2002). Hundred twenty nine (129) cases of exocrine pancreatic tumors had been counted. It was about 71 men and 58 women of middle age of 56, 96 years. The length of middle evolution of the illness was of 8 months. The most frequent sign was jaundice, recovered at 80.9% of patients. Followed the thinning (79%), the pain (69%), the digestive stenosis (35%). Ultrasonography, scanner and x-ray of lungs permitted to make the diagnosis and the balance of extension. A laparoscopy had been made at 13 patients. A clinic and radiological classification had been used to distribute the tumors in 3 stages. At 46 patients in III stage, a therapeutic abstention had been decided. Patients to the II stage (n=77) had benefitted a palliative surgical treatment. It was about 74 biliary and digestive shunt and 3 alcoholic splanchnicectomy. The 6 patient to the I stage had benefitted a surgical resection. The middle hospitalization length was of 10.75 days. The rate of morbidity was 45.78%. Mortality was 29%. The median survival was of 3.6 months. The palliative surgical treatment had again indications facing these obstructive and locally advanced tumors. But the salute will come from the precocious diagnosis of these tumors to hope for a curative gesture.