EXTENDED RADICAL WHIPPLE RESECTION FOR CANCER OF THE PANCREATIC HEAD - OPERATIVE PROCEDURE AND RESULTS

Pancreatoduodenectomy is now the most fundamental operation for cancer of the pancreatic head. However, with the conventional operative proc edure, the resection rate is low and long-term results are extremely p oor. We introduced an extended radical Whipple operation in 1978 to im prove surgical curability. Systemic dissection of extended lymph nodes and plexuses and en bloc resection of the portal vein was the basic c oncept. The resection rate for cancer of the pancreatic head has impro ved from 7-20 to 50%. The curative resection rate has also improved fr om 10 to 40-50%. The extended procedure did not increase the risk of t he Whipple operation. When curative surgery was performed, good long-t erm survival was expected even in cases of extensive invasion to the p ortal vein. As a result, 11 patients who underwent curative surgery ha ve survived for a long period of time. At present, however, the majori ty of patients are in an advanced stage at diagnosis and extended radi cal operation plays an important role in the curative therapy for this condition.