Whipple's Operation for Carcinoma of the Pancreatic Head and the Ampullary Region: Short- and Long-Term Results

Abstract

Background and Methods: In this retrospective review short- and long-term perspectives have been evaluated for 108 patients who, during 1982 through 1992, had Whipple's operation performed for carcinoma of the pancreatic head (PC, n = 63) or the ampullary region (AC, n = 45). In 24 patients the operation was not radical (21 with PC and 3 with AC). Results: Total perioperative morbidity was 60%, and 13 patients (12%) died within 30 days of operation. This decreased from 15.2% in the first half of the study period to 8.2% in the second half. Recurrence occurred in 56.2% of the remaining 73 patients, with no significant differences between PC and AC. Recurrence was related to regional lymph node metastases and poor tumour differentiation. Overall 5-year survival was 7.4% for PC and 24.8% for AC. For patients with radically excised tumours surviving 30 days the 5-year survival rates were 13.1% for PC and 30% for AC. Conclusion: Careful preoperative evaluation is still of great importance.