Extended Pancreatic Resection for Carcinoma of the Pancreas

  • Tatsushi Naganuma
  • Yoshifumi Kawarada


The frequency of occurrence of cancer of the pancreas has been steadily increasing in both sexes in Japan, as in Western countries, and pancreatic carcinoma is now the fourth leading cause of cancer deaths in Japan.


Pancreatic Cancer Total Pancreatectomy Surgical Stage Pancreatic Cancer Resection Portal Vein Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kawarada Y, Nemoto A, and Mizumoto R. Surgical treatment for carcinoma of the head of the pancreas. In: Takada T (eds), New frontiers in hepato-biliary-pancreatic surgery, Bangkok Medical, Bangkok, 1993; pp. 196–199.Google Scholar
  2. 2.
    Trede M, Schwall G, and Saeger HD. Survival after pancreatectomy: 118 consecutive resections without an operative mortality. Ann Surg 1990; 211:447–458.PubMedCrossRefGoogle Scholar
  3. 3.
    Crist DW, Sitzmann JV, and Cameron JL. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann Surg 1987; 206:358–365.PubMedCrossRefGoogle Scholar
  4. 4.
    Cameron JL, Crist DW, Sitzmann JV, et al. Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer. Am J Surg 1991; 161:120–125.PubMedCrossRefGoogle Scholar
  5. 5.
    Yeo CH, Cameron JL, Lillemoe KD, Sitzmann JV, Hruban RH, Goodman SN, et al. Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg 1995; 221:721–733.PubMedCrossRefGoogle Scholar
  6. 6.
    Geer RJ and Brennan MF. Prognostic factors for survival after resection of pancreatic adenocarcinoma. Am J Surg 1993; 165:68–73.PubMedCrossRefGoogle Scholar
  7. 7.
    Wilette CG, Lewandrowsky K, and Warshaw AL. Resection margins in carcinoma of the head of the pancreas: implications for radiation therapy. Ann Surg 1991; 214:648–656.CrossRefGoogle Scholar
  8. 8.
    Japan Pancreas Society. General rules for the study of pancreatic cancer, 4th ed, Kanehara, Tokyo, 1993 (in Japanese).Google Scholar
  9. 9.
    World Health Organization. Handbook for reporting results of cancer treatment, WHO, Geneva, 1979.Google Scholar
  10. 10.
    Japan Pancreas Society. Classification of pancreatic cancer, 1st ed. Kanehara, Tokyo, 1996.Google Scholar
  11. 11.
    Lucas CE, Ledgerwood AM, Saxe JM, Bender JS, and Lucas WF. Antrectomy, a safe and effective bypass for unresectable pancreatic cancer. Arch Surg 1994; 129:795–799.PubMedCrossRefGoogle Scholar
  12. 12.
    Slim K, Pezet D, Riff Y, and Chipponi J. Antral exclusion as an adjunct to palliative gastrojejunostomy for cancer of the pancreas. Press Med 1996; 25:674–676 (in French).Google Scholar
  13. 13.
    (Hermanek P, Sobin LH eds) UICC TNM classification of malignant tumours, 4th ed., 2nd revision, Springer, Berlin, 1992.Google Scholar
  14. 14.
    Howard JM. Pancreatico-duodenectomy: forty-one consecutive Whipple resections without and operative mortality. Ann Surg 1968; 168:629-640.Google Scholar
  15. 15.
    Fortner JG. Regional resection of cancer of the pancreas: a new surgical approach. Surgery 1973; 73:658–662.Google Scholar
  16. 16.
    Ashley SW and Reber HA. Surgical management of exocrine pancreatic cancer. In: Go VLW, (eds), The pancreas: biology, pathobiology, and disease, 2nd ed., Raven, New York 1993; pp. 913–929.Google Scholar
  17. 17.
    Warshaw AL. Pancreatic carcinoma. New Eng J Med 1992; 326:455–465.PubMedCrossRefGoogle Scholar
  18. 18.
    Warshaw AL and Swanson RS. What’s new in general surgery; pancreatic cancer in 1988. Ann Surg 1988; 208:541–553.PubMedCrossRefGoogle Scholar
  19. 19.
    Gudjonsson B. Cancer of the pancreas: 50 years of surgery. Cancer 1992; 60:2284–2303.CrossRefGoogle Scholar
  20. 20.
    Sindelar WF. Clinical experience with regional pancreatectomy for adenocarcinoma of the pancreas. Arch Surg 1989; 124:127–132.PubMedCrossRefGoogle Scholar
  21. 21.
    Castillo CF, Rattner DW, and Warshaw AL. Standards for pancreatic resection in the 1990s. Arch Surg 1995; 130:295–300.CrossRefGoogle Scholar
  22. 22.
    Saito Y. The annual report of pancreatic cancer. Pancreatic Cancer Register Committee, Japan Pancreas Society 1994. Suizo 1995; 10:535–564. (in Japanese)Google Scholar
  23. 23.
    Hanyu F, Suzuki M, and Imaizumi T. Whipple operation for pancreatic carcinoma: Japanese experience. In: Beger HG et al. (eds), Standards in pancreatic surgery, Springer-Verlag, Berlin 1993; pp. 647–653.Google Scholar
  24. 24.
    Ishikawa O, Ohhigashi H, Sasaki Y, Kabuto T, Fukuda I, Furukawa H, Imaoka S, and Iwanaga T. Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head. Ann Surg 1988; 208:215–220.PubMedCrossRefGoogle Scholar
  25. 25.
    Saito Y. The annual report of pancreatic cancer. Pancreatic Cancer Register Committee 1991; 1981–1990, Japan Pancreas Society (in Japanese).Google Scholar
  26. 26.
    Ishikawa O. Surgical technique, curability and postoperative quality of life in an extended pancreatectomy for adenocarcinoma of the pancreas. Hepato-gastroenterology 1996; 320–325.Google Scholar
  27. 27.
    Noguchi T, Vaidya P, and Kawarada Y. Surgical treatment and prognostic factors in TS1 carcinoma of the pancreas. J Hep Bil Pancr Surg 1995; 2:376–383.CrossRefGoogle Scholar
  28. 28.
    Satake K, Nishikawa H, Yokomatsu H, Kawazoe Y, Kim KS, Haku A, and Umeyama K. Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas. Surg Gynecol Obstet 1992; 175:259–265.PubMedGoogle Scholar
  29. 29.
    Takahashi S, Ogata Y, Miyazaki H, Maeda D, Murai S, Yamataka K, and Tsuzuki T. Aggressive surgery for pancreatic duct cell cancer: feasibility, validity, limitations. World J. Surg 1995; 19:653–660.PubMedCrossRefGoogle Scholar
  30. 30.
    Ishikawa O, Ohigashi H, Iamoka S, Furukawa H, Sasaki Y, Fujita M, Kuroda C, and Iwanaga T. Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein. Ann Surg 1991; 215:231–236.CrossRefGoogle Scholar
  31. 31.
    Nakao A, Harada A, Nonami T, Kaneko T, Inoue S, and Takagi H. Clinical significance of portal invasion by pancreatic head carcinoma. Surgery 1995; 117:50–55.PubMedCrossRefGoogle Scholar
  32. 32.
    Ozaki H. Modern surgical treatment of pancreatic cancer. Int J Pancreatol 1994; 16:121–129.PubMedGoogle Scholar
  33. 33.
    van Heerden JA, Mcilrath DC, Ilstrup DM, and Weiland LH. Total pancreatectomy for ductal adenocarcinoma of the pancreas. An update. World J Surg 1988; 12:668–662.Google Scholar
  34. 34.
    Traverso LM and Longmire WP. Preservation of the pylorus in pancreaticoduodenectomy. Surg Gynecol Obstet 1978; 146:959–962.PubMedGoogle Scholar
  35. 35.
    Braasch JW, Rossi RL, Watkins EJR, Deziel DJ, and Winter PF. Pyloric and gastric preserving pancreatic resection. Ann Surg 1986; 204:411–418.PubMedCrossRefGoogle Scholar
  36. 36.
    Roder JD, Stein HJ, Huttle W, and Siewert JR. Pylorus preserving versus standard pancreticoduodenectomy: an analysis of 110 pancreatic and periampullary carcinoma. Br J Surg 1992; 79:152–155.PubMedCrossRefGoogle Scholar
  37. 37.
    Suzuki T, Hamanaka Y, Shinagawa Y, Wadamori K, Iizuka N, Tanaka A, and Ueno T. Pylorus-preserving pancreatoduodenctomy in Japan: history and present status. J Hep Bil Pancr Surg 1994; 4:379–384.CrossRefGoogle Scholar
  38. 38.
    Takada T. Pylorus-preserving pancreato-duodenectomy: Technique and indications. Hepato-gastroenterology 1993; 40:422–425.PubMedGoogle Scholar
  39. 39.
    Nakase A, Matsumoto Y, Uchida K, and Honjo I. Surgical treatment of cancer of the pancreas and the periampullary region: cumulative results in 57 institutions in Japan. Ann Surg 1977; 185:52–57.PubMedCrossRefGoogle Scholar
  40. 40.
    Nagakawa T, Konishi I, Ueno K, Ohta T, Kiyama T, Kanno M, Kayahara M, and Miyazaki I. The results and problems of extensive radical surgery for carcinoma of the head of the pancreas. Jap J Surg 1991; 21:262–267.CrossRefGoogle Scholar
  41. 41.
    Nagakawa T. Pancreaticoduodenectomy. Geka Shinryo 1996; 38:437–444 (in Japanese).Google Scholar
  42. 42.
    Manabe T, Baba N, Nonaka A, Asano N, Yamaki K, Shibamoto Y, et al. Combined treatment using radiotherapy for carcinoma of the pancreas involving the adjacent vessels. Int Surg 1988; 73:153-156.Google Scholar
  43. 43.
    Manabe T, Ohshio G, Baba N, Miyashita T, Asano N, Tamura K, et al. Radical pancreatectomy for ductal cell carcinoma of the head of the pancreas. Cancer 1989; 64:1132–1137.PubMedCrossRefGoogle Scholar
  44. 44.
    Matsuno S and Sato T. Surgical treatment for carcinoma of the pancreas. Am. J. Surg 1988; 152:499–504.CrossRefGoogle Scholar
  45. 45.
    Tsuchiya R, Tsunoda T, and Yamaguchi T. Operation of choice for resectable carcinoma of the head of the pancreas. Int J Pancreatol 1990; 6:295–306.PubMedGoogle Scholar
  46. 46.
    Hanyu F, Imaizumi T, Nakasako T, Harada N, Hatori T, Ozawa F, Suzuki T, and Tenma N. Pancreatic cancer. Gastroenterol Surg 1995; 18:323–330 (in Japanese).Google Scholar
  47. 47.
    Nakao A, Harada K, Nonami T, Kaneko T, Inoue S, Takeuchi A, et al. Radical surgery and adjuvant therapy for carcinoma of the pancreatic head region. Jpn J Gastroenterol Surg 1994; 2341–2346 (in Japanese).Google Scholar
  48. 48.
    Nitecki SS, Sarr MG, Colby TV, and van Heerden JA. Long-term survival after resection of ductal carcinoma of the pancreas. Is it really improving? Ann Surg 1995; 221:59-61.Google Scholar
  49. 49.
    Griffin JF, Smallery SR, Jewell W, Paradelo JC, Reymond RD, Hassanein RES, and Evans RG. Patterns of failure after curative resection of pancreatic carcinoma. Cancer 1990; 66:56–61.PubMedCrossRefGoogle Scholar
  50. 50.
    Wade TP, Radford DM, Virgo KS, and Jonson FE. Complications and outcomes in the treatment of pancreatic adenocarcinoma in the United States veteran. J Am Coll Surg 1994; 179:38–48.PubMedGoogle Scholar
  51. 51.
    Gall FP, Kessler H, and Hermanek P. Surgical treatment of ductal pancreatic carcinoma. Eur J Surg Oncol 1991; 17:173–181.PubMedGoogle Scholar
  52. 52.
    Gudjonsson B. Carcinoma of the pancreas: critical analysis of costs, results of resections, and the need for standardized reporting. J Am Coll Surg 1995; 181:483–503.PubMedGoogle Scholar
  53. 53.
    Warren KW, Choe DS, Plaza J, and Relihan M. Results of radical resection for periampullary cancer. Ann Surg 1975; 181:534–540.PubMedCrossRefGoogle Scholar
  54. 54.
    Hannoun L, Christophe M, Ribeiro J, Nordlinger B, Elrinwini M, Tiret E, and Parc R. A report of forty-four instances of pancreaticoduodenal resection in patients more than seventy years of age. Surg Gynecol Obstet 1993; 177:556–560.PubMedGoogle Scholar
  55. 55.
    Baumel H, Huguier M, Mandersheid JC, Fabre JM, Houry S, and Fagot H. Results of resection for cancer of the exocrine pancreas: a study from the French Association of Surgery. Br J Surg 1994; 81:102–107.PubMedCrossRefGoogle Scholar
  56. 56.
    Tannapfel A, Wittekind C, and Hunefeld G. Ductal adenocaricinoma of the pancreas. Histopathological features and prognosis. Int J Pancreatol 1992; 12:145–152.Google Scholar
  57. 57.
    Kiimmerele F and Ruckert K. Surgical treatment of pancreatic cancer. World J Surg 1984; 8:889–894.CrossRefGoogle Scholar
  58. 58.
    Tsuchiya R, Harada N, Tsunoda T, Miyamoto T, and Ura K. Long-term survivors after operation on carcinoma of the pancreas. Int J Pancreatol 1988; 3:491–496.PubMedGoogle Scholar
  59. 59.
    Beger HG, Link KH, Poch B, and Gansauge F. Pancreatic cancer-rencent progress in diagnosis and treatment, pancreas. In: Neoptolemos JP, (eds), Pancreatic cancer, et al., Blackwell, London 1996; pp. 227–235 In: Go VLN, (eds), The pancreas: biology, pathobiology, and disease, 2nd ed., Raven, New York 1993; pp. 913–929.Google Scholar
  60. 60.
    Kawarada Y, Naganuma T, Vaidya P, et al. Extended resection for cancer of the pancreas and prognostic factors. Asian J Surg (in print).Google Scholar
  61. 61.
    Böttger TC, Strokel S, Wellek S, Stockle M, and Junginger T. Factors influencing survival after resection of pancreatic cancer. Cancer 1994; 73:63–73.PubMedCrossRefGoogle Scholar
  62. 62.
    Fortner JS, Kimustra DS, Senie RT, and Maclean BJ. Tumor size is the primary prognosticator for pancreatic cancer after regional pancreatectomy. Ann Surg 1996; 223:147–153.PubMedCrossRefGoogle Scholar
  63. 63.
    Cubilla AC, Fortner J, and Fitzgerald PJ. Lymph node involvement in carcinoma of the head of the pancreas. Cancer 1978; 41:880–887.PubMedCrossRefGoogle Scholar
  64. 64.
    Vaidya P, Isaji S, Kato K, Tanigawa K, Okamura Y, Ogura Y, et al. Adjuvant therapy following resection of pancreatic head carcinoma according to the histopathological and biological features. In: Recent advances in management of digestive cancers, Springer-Verlag/Tokyo Press, Hong Kong, 1993; pp. 779–781.CrossRefGoogle Scholar
  65. 65.
    Saito Y. The annual report of pancreatic cancer. Pancreatic Cancer Register Committee, Japan Pancreas Society 1993. Suizo 1994; 9:499–527 (in Japanese).Google Scholar
  66. 66.
    Cangemi V, Volpino P, Mingazini P, Fiori E, Gentili S, Ansali A, and Piat G. Role of surgery in ductal carcinoma of the pancreas. Int Surg 1992; 77:158-163.Google Scholar
  67. 67.
    Martin FM, Rossi RL, Dorrucci V, Silverman L, and Braasch JW. Clinical and pathologic correlations in patients with periampullary tumors. Arch Surg 1990; 125:723–726.PubMedCrossRefGoogle Scholar
  68. 68.
    Funovics JM, Kamer J, Pratschner Th, and Fritsch A. Current trends in the management of carcinoma of the pancreatic head. Hepat-gastroenterology 1989; 36:450–455.Google Scholar
  69. 69.
    Conlon K, Kimstra DS, and Brennan MF. Long-term survival after curative resection for pancreatic ductal adenocarcinoma: clinicopathologic analysis of 5-year survivors. Ann Surg 1996; 223:273–279.PubMedCrossRefGoogle Scholar
  70. 70.
    Lillemoe Kd, Cameron JL, Yeo CJ, Sohn TA, Nakeeb A, Sauter PK, et al. Pancreaticoduodenectomy. Does it have a role in the palliation of pancreatic cancer? Ann Surg 1996; 223:718–728.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Tatsushi Naganuma
  • Yoshifumi Kawarada

There are no affiliations available

Personalised recommendations