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Problems of Surgical Management of Pancreatic Cancer I. Miyazaki 1 , T. Nagakawa 1 1The Second Department of Surgery, School of Medicine, Kanazawa University pp.619-626
Published Date 1980/6/25
DOI https://doi.org/10.11477/mf.1403106903
  • Abstract
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 As compared with other cancers of the digestive tract, the results of treatment for pancreatic cancer are disappointing not only in the rate of resectability and operative mortality but also in the end results, although various efforts have been made up to now.

 For better results it goes without saying that detection of small cancer of the pancreas is very important, and its surgical operation, the basic treatment for it, demands improvement of safer and more effective method of curative resection. More careful pre- and postoperative management of the patient is also advisable.

 From this point of view, we have reviewed 209 such patients operated on in our department during the past 20 years. The results of surgical treatment are introduced along with the relationship of development patterns and prognosis. Patterns of recurrence in autopsied patients are also studied. We have discussed some mooted points for the resection of the pancreas with reference to the literature.

 As a result, we have come to the conclusion that for lowering operative mortality it is important to improve methods of easing preoperative jaundice, to introduce central venous nutrition and to better the way of pancreato-jejunal anastomosis. For the prevention of recurrence it is most important not only to painstakingly extirpate retroperitoneal and peripancreatic lymph nodes but also to resect completely any involved lymph nodes along with dissection of the plexus of the proximal part of the celiac artery and superior mesenteric artery. Stress is also laid on the necessity of total pancreatectomy and combined resection of the portal vein. On the other hand, reference is made to still unsolved problems regarding disorders of digestion and absorption and those of glucose metabolism, as they are important in the management of pathologie pictures presented by pancreatectomy.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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