Total Pancreatectomy: Indication and Early and Late Postoperative Problems

  • M. Trede
  • F. Kümmerle
  • T. White
  • L. C. Carey
Conference paper


The panel and the audience agreed that total pancreatectomy is not a routine operation for every case of carcinoma of the pancreas. Whipple’s procedure is sufficient for well-localized periampullary tumors, but there is a case for total pancreatectomy as a routine procedure for all cases of ductal carcinoma that have not gone beyond the boundaries of the pancreas and its immediate regional lymph nodes. In the view of the surgeons present, there are eight reasons for doing a total pancreatectomy in cases of carcinoma of the pancreas:
  1. 1)

    There is no carcinoma left at the level of resection, as is the case in some patients operated on with Whipple’s procedure only.

  2. 2)

    There are a number of cases with proven multicentric carcinoma who have a chance for cure only with total pancreatectomy.

  3. 3)

    Diffuse carcinomatosis of the pancreatic gland appears to occur in some 6% of cases.

  4. 4)

    It is Known that free Malignant cells can float in the pancreatic duct and are sometimes asporated during the preoperative examination, so that radical carcinoma surgery would here also logically mean that only total pancreatectomy can cure the patient.



Acute Pancreatitis Chronic Pancreatitis Pancreatic Duct Obstructive Jaundice Total Pancreatectomy 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1980

Authors and Affiliations

  • M. Trede
    • 1
  • F. Kümmerle
    • 2
  • T. White
    • 3
  • L. C. Carey
    • 4
  1. 1.MannheimGermany
  2. 2.MainzGermany
  3. 3.SeattleUSA
  4. 4.ColumbusUSA

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