[Pancreatic cancer from the viewpoint of the surgeon]

The incidence of carcinoma of the exocrine pancreas has gone up by factors of something between 2 and 4 in countries of advanced civilization over the past 30 years. Modern diagnostic methods have enabled safe detection of the carcinoma in 85 per cent of all cases. Laparotomy is justified in situations in which the operability of a pancreas tumour cannot be reliably established by other approaches. Radical therapy should include cephalic or total duodenopancreatectomy and romal of regional lymph nodes. Diffuse metastasation or infiltration of the mesenteric superior arteries and veins, the hepatic artery, and the portal vein result in inoperability. Operations for exocrine pancreas carcinoma were performed on 226 patients at the Surgical Department of Charité, between 1979 and 1985. Tumours were radically removed in 104 cases. Surgical mortality accounted for 14 per cent. Chemotherapy or radiotherapy of pancreas carcinoma should be reverified for their life-extending effectiveness. Aggravating fatty degeneration of the liver was found to develop two years after pancreatectomy and calls for modified treatment.