[Whipple's resection in cancer of Vater's ampulla and the pancreatic head]

A review is presented of 62 Whipple's resections between 1962 and 1984 for adenocarcinoma of the choledocho-duodenal junction (CDJ) and pancreatic head (PH). The operation was radical in 17 patients with CDJ (94%) and in 34 patients with PH cancer (77%). The cumulative 5-year survival rates were 22% and 9%, respectively. The overall perioperative mortality was 23%, but was lowered to 11% during the last five years. Histology, size of tumour and age also influenced survival. Sixteen of the 32 radically operated patients who survived more than three months had a period without pain. Whipple's resection is still the only hope for cure in otherwise fit patients with CDJ or PH cancer, estimated to be radically resectable by pre- and peroperative investigations. The operation should be centralized in a few departments.