January 2014

J Surg Oncol. 2014 Jan 7. [Epub ahead of print]

Complications and survival associated with operative procedures in patients with unresectable pancreatic head adenocarcinoma

Spanheimer PM, Cyr AR, Liao J, Johlin FC, Hoshi H, Howe JR, Mezhir JJ

In a retrospective chart review study from 1997 to 2013 in a US hospital, 50 patients with adenocarcinoma of the pancreatic head who underwent surgical exploration with curative intent but who did not undergo pancreatectomy were evaluated (these account for about 20% of patients taken for resection). They were unresectable due to metastatic disease or due to vascular invasion. 68% of these patients had a palliative procedure performed including double bypass, biliary bypass, gastrojejunostomy or cholecystectomy. Complications occurred in 44% of patients who had a palliative operation. They also had a longer hospital stay and reduced survival. In view of this the authors emphasise the importance of identifying unresectable disease prior to surgery and support a selective approach to palliative operations.