[Palliative treatment for unresectable cases of pancreatic carcinoma]

Palliative treatment have been performed in 50 cases of unresectable pancreatic carcinoma during these nine years. There were 36 in the head and 14 in the body and tail on the location of the tumor. Operation was performed in 35 cases (70%) and about 60% of which were diagnosed as unresectable for liver metastases. Prophylactic gastroenterostomy concomitant with biliary bypass is considered to be the most suitable procedure and should be performed routinely regardless of duodenal obstruction. Choledochojejunostomy (Roux-en-Y) and gastrectomy (Billorth-II) were considered advantageous for favorable long-term bile drainage and to prevent hematemesis. Splanchnicetomy proved to alleviate pain in 87.5% and is recommended to perform at the time of initial laparotomy. Postoperative adjuvant chemotherapy was performed in 40% of the cases. Arterial infusion chemotherapy was found most effective to prolong survival. The patients who received palliative treatment survived 6.5 months on the average: Mean survival was 7.3 months in the former cases and 3.8 in the latter. Six patients (12%) survived more then one year, and no significant difference in location or size could be found.