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Reduction of Mortality and Morbidity in Pancreatoduodenectomy

Arch Surg. 1962;85(2):260-270. doi:10.1001/archsurg.1962.01310020090019.
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Until Whipple1 and Brunschwig2 independently reported survival after resections of the head of the pancreas for carcinoma, malignancies which were located in the region of the head of the pancreas had been considered unremovable because of their anatomical position. The welcome contributions of Whipple and Brunschwig indicated that malignancies which arose from the head of the pancreas, the ampulla of Vater, the common duct, and the duodenum (as well as an occasional gastric neoplasm which directly invaded the underlying pancreatic head) might now be removed. This operation has since been carried out by many surgeons. However, the operative mortality reported has been discouragingly high and the number of long-term survivals has been few. Enough cases have now been done, however, that we know that the long-term survival in part may be an inherent quality of the type of tumor. It seems that long-term survival of ampullary tumors is


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