The results of surgery for carcinoma of the pancreas

A retrospective analysis was performed on 104 consecutive patients with carcinoma of the pancreas treated between 1970 and 1974 inclusive. Fifty-three per cent underwent palliative bypass, 13% laparotomy only, 6% had a Whipple operation, 7% various miscellaneous operations, and 21% did not undergo operation. The operative mortality of palliative bypass and diagnostic laparotomy was 13% and 71% respectively. The mean survival of patients after biliary bypass was 6.7 months. Seven patients undergoing bypass had tumours of the pancreatic head, five centimetres or less in diameter, and apparently localized disease, and their means survival was 15.9 months. The mean survival of the four patients surviving radical surgery was 15.5 months. There were no cures. It was concluded that cholecystojejunostomy without enteroenterostomy was an appropriate biliary bypass operation and that diagnostic laparotomy should be avoided in patients without obstructive jaundice and with disseminated disease.