Appraisal of Extended Radical Operations for Carcinomas of the Pancreatic Head Region -Curability and Postoperative Quality of LIfe-

Keiichi Ueno, Takukazu Nagakawa, Tetsuo Ohta, Masato Kayahara, Kazuhiro Mori, Tatsuo Nakano, Toshiya Takeda, Itsuo Miyazaki

Department of Surgery (II), Kanazawa University School of Medicine

We performed extended radical operations for carcinomas of the pancreatic head region. These included extended paraaortic lymph node dissection, portal vein resection and complete dissection of connective tissues surrounding the superior mesenteric artery, (SMA). We studied the efficacy of a complete dissection surrounding the SMA. We looked at curability and postoperative quality of life. Frequently the carcinomas of the pancreatic head region invaded the plexus and metastasized to the lymph nodes surrounding the SMA. In particular, in the cases of pancreatic cancer, the incidence of invasion to plexus was 68.9% and that of metastasis to the lymph nodes was 36.1%. We investigated the postoperative quality of life of the 112 patients who received pancreatoduodenectomy or total pancreatectomy. The patients who received an extended radical operation remained hospitalized for a long time after the operation. Also they frequently had diabetes, incurable diarrhea and fatty liver. In conclusion, the results of our therapy suggest that complete dissection surrounding the SMA for a patient with carcinoma of the pancreatic head region is necessary. Intensive postoperative care is also very important in that it will improve the patient's quality of life.

Key words
carcinoma of the pancreatic head region, dissection surrounding the superior mesenteric artery, quality of life

Reprint requests
Keiichi Ueno Department of Surgery (II), Kanazawa University, School of Medicine
13-1 Takara-machi, Kanazawa, 920 JAPAN

Accepted
July 6, 1992

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