SURGICAL RESECTION FOR CARCINOMA OF THE PANCREAS - A HISTORICAL OVERVIEW

Although attempts to treat pancreatic cancer were made at the end of t he nineteenth century, there was no active interest in this field of s urgery until 1935 when Whipple and his associates developed and popula rized the technique for a two-stage pancreaticoduodectomy. Several mod ifications of the original Whipple operation were made in the 1940s. T otal pancreatectomy and regional pancreatectomy were introduced in the surgical armamentarium against pancreatic cancer, but they did not ga in wide acceptance. Pylorus-preserving pancreaticoduodectomy was intro duced in 1978, but its role in the management of pancreatic cancer nee ds to be more clearly defined. The operative mortality of pancreatic r esections has dramatically declined in large specialized centers durin g the last decade. A significant improvement in long-term survival was also reported in recent series. Despite the decline in operative mort ality and the improved long-term survival after resection for pancreat ic cancer, the overall prognosis of this disease remains dismal becaus e of the lack of methods for early diagnosis. Future investigations sh ould focus in the areas of early detection and more effective manageme nt approaches for locally advanced disease. (C) 1995 Wiley-Liss, Inc.