The 5-year survival rate following the Whipple resection for pancreati
c cancer is still only 10%. There is some evidence, especially from Ja
pan, that more extensive resections than are commonly done with the st
andard Whipple operation may prolong survival. Many of the published s
eries that compare the two operations, however, are retrospective and
uncontrolled for the stage of disease. Such comparisons, therefore, ar
e unjustified. Before any modification of the standard pancreaticoduod
enectomy is adopted, an appropriately designed study should be perform
ed to confirm its efficacy.