Abstract
Current reviews of the treatment of cancer of the pancreas, most of which evaluate cases treated in the past one or two decades, continue to present discouraging results. The advantages and disadvantages of performing a resection must be carefully evaluated for each patient. The dilemma of resection should be discussed with the patient before operation and when capable he or she should influence the decisions the surgeon anticipates facing during the operation. Pancreatoduodenectomy is the treatment of choice for carefully selected cases of carcinoma of the head of the pancreas and other periampullary carcinomas. Total pancreatectomy has not, at this point, been shown to provide sufficient advantages to warrant routine adoption as the treatment of choice when resection is to be performed.
Résumé
L'étude des séries de cancers du pancréas traités chirurgicalement au cours de la dernière décade ou des deux dernières décades montre que les résultats sont décourageants. Il convient donc d'apprécier avec précision les avantages et les inconvénients de l'exérèse en fonction de chaque malade atteint de cancer du pancréas. Le problème doit être discuté avec lui car de ses désirs peuvent dépendre les décisions opératoires.
La duodénopancréatectomie représente le traitement de choix des cancers de la tête du pancréas et des cancers périampullaires soigneusement selectionnés. La pancréatectomie totale, à ce jour, ne paraît pas présenter d'avantages suffisants pour supplanter l'opération de Whipple.
Resumen
Revisiones corrientes sobre el tratamiento del cáncer del páncreas, la mayoría de las cuales evalúan casos tratados en las pasadas dos décadas, continúan presentando resultados desalentadores. Las ventajas y desventajas de realizar una resección deben ser juzgadas cuidadosamente en cada paciente individual. El dilema sobre la resección debe ser discutido con el paciente antes de la operatión y éste, si lo puede hacer, debe influir sobre las decisiones que el cirujano prevea va a encontrar durante la operación.
La pancreatoduodenectomía es el tratamiento de escogencia para casos cuidadosamente seleccionados de carcinoma de cabeza del páncreas y de otros carcinomas periampularios. La pancreatectomía total, un procedimiento que según revisión de la literatura reciente esta siendo utilizado con creciente frecuencia, no ha logrado hasta la fecha demostrar suficientes ventajas para justificar su adoption rutinaria como el tratamiento de escogencia en aquellos pacientes seleccionados para resección.
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Longmire, W.P. Cancer of the pancreas: Palliative operation, Whipple procedure, or total pancreatectomy. World J. Surg. 8, 872–879 (1984). https://doi.org/10.1007/BF01656027
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DOI: https://doi.org/10.1007/BF01656027