PANCREATICODUODENECTOMY FOR NONPERIAMPULLARY PRIMARY TUMORS

INTRODUCTION: This review was performed to evaluate the outcome of pat ients undergoing pancreaticoduodenectomy (PD) for isolated metastatic or locally advanced nonperiampullary tumors at a single institution ov er a 13-year period. METHODS: Between 1983 and 1996, patients undergoi ng PD for metastatic or locally advanced nonperiampullary malignancies were identified. Medical records were reviewed and outcome factors an d survival data analyzed. RESULTS: Eighteen patients were identified, The primary tumor histopathology included colon (n = 7), gastric (n = 4), renal cell (n = 3), lung (n = 2), bladder (n = 1), and melanoma (n = 1). The median length of hospital stay was 15 days (6 to 48) with o ne perioperative death (5.5%). The median tumor size was 5.5 cm (0.8 t o 11.5), and 7 patients had positive peripancreatic lymph nodes, The m edian survival was 40 months, with a 5-year survival of 35%. CONCLUSIO NS: Pancreaticoduodenectomy for nonperiampullary malignancy is infrequ ently indicated. However, in the absence of widely metastatic disease, PD should be considered for locally advanced tumors or isolated metas tatic malignancy. (C) 1997 by Excerpta Medica, Inc.