WHIPPLE TECHNIQUE FOR CAPUT PANCREATIC AN D PERIAMPULAR TUMORS

Between 1986 and 1991 35 partial duodenopancreatectomies have been per formed in the Clinic for visceral surgery of the University of Berne. 17 for adenocarcinoma of the pancreas and 18 for miscellaneous maligna nt or semi-malignant pathologies such as ampullary or duodenal carcino mas, cystadenomas and distal bile duct carcinomas. The mortality was 5 %. Postoperative complication were observed in 50% of cases. Leak at t he pancraticojejunal anastomosis was the most common surgical complica tion but healed under conservative treatment with somatostatin within few days in 5 of 6 cases. The median survival for patients with adenoc arcinoma of the pancreas is 550 days, for patients with other patholog ies 1200 days with some long-term survival in ampullary carcinomas. Th ese results show on one hand that this kind of surgery can be realized with acceptable morbidity and mortality rate, on the other hand that further clinical trials in systemic adjuvant treatment are indicated e specially in pancreatic cancer to improve the disappointing long-term results.