Is pancreatic cancer still an uncurable disease?

Introduction: Authors evaluate the experiences gained with surgery for pancreatic tumors between June 2005 and December 2008.

Patients: During the last 42 months 50 patients were operated for pancreatic tumour by the same team. 46 patients suffered from malignant tumors and 4 of benign or borderline leasions. The benign conditionss were either cystadenomas (1 case) or duodenal adenomas (2 cases) and intraductal papillary mucinous neoplasia (IPMN).

Discussion: We performed 2 pancreatic head resections (1 Whipple and 1 pylorus preserving pancreato-duodenectomy – PPPD) and 1 distal pancreatic resection for benign tumors. 1 patient received total pancreato-duodenectomy for IPMN. From the 46 malignant tumours we resected 26 patients. This means 56% resecability rate. In this group we did 18 PPPD-s,, 3 Whipple procedures, 5 distal resections. We had some surgical complications: two leaks from the pancreato-gastric anastomosis. This was successfully treated by converting the operation for total pancreatectomy. We reoperated one patient for bleeding, one for subphrenic abscess, one for abdominal wall disruption. 20 palliative procedures were needed – biliary and/or enteral diversions. We lost 4 patients, 3 from the resected group. Two of these had multivisceral resections. We also lost 1 patient from the palliation group who developed insufficiency of a hepato-jejunostomy.

Conclusion: Pancreatic surgery seems to be feasible and safe at our department. The resecability rate was highly above the ratio cited in the literature. Multivisceral resections may carry unacceptably high risk.