Preoperative Diagnosis and Surgical Management for Pancreatic Cancer

Tadao Manabe, Gakuji Ohshio, Takayoshi Tobe

First Department of Surgery, Faculty of Medicine, Kyoto University

In order to perform a curative operation for pancreatic cancer, an accurate diagnosis of retroperitoneal invasion and vessel involvement is necessary. CT scanning and selective angiography are very helpful to assess the operability of the cancer. If no major arteries are involved, it may be possible to perform curative pancreatectomy by extended pancreatectomy with sufficient lymph node clearance and excision of the connective tissue around the pancreas. When involvement of the portal system is suspected, resection of the portal system combined with pancreatectomy should be performed. The resection of the connective tissue should be accomplished by the skeletonization of the superior mesenteric artery and paraaortic regions. Furthermore, combined modality treatment using radiotherapy and chemotherapy should be employed to prevent microscopic lesions and distant metastasis.

Key words
pancreatic cancer, retroperitoneal invasion, extended pancreatectomy

Reprint requests
Tadao Manabe First Department of Surgery, Faculty of Medicine, Kyoto University 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, 606 JAPAN

Accepted
November 20, 1991

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