Abstract
The best chance for cure of pancreatic cancer is surgical resection. This is also possible in case of adjacent organ involvement of, for example, duodenum, portal vein, or colon. Pancreatic tumours may develop to a large size without developing metastases. Irresectable tumours without distant metastases can successfully be treated with radiotherapy and 5-fluorouracil and, in some cases, be resected during a second-look operation. Thus there is no contraindication for laparotomy in case of large size. Pre-operatively estimated size of the tumour is not of prognostic value for resection. Altogether, laparotomy is contraindicated only in case of distant mestastases and high operative risk.
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