Radical Pancreatoduodenectomy for Cancer of the Papilla of Vater

Onye E. Akwari, MD; Jonathan A. van Heerden, MB, ChB, FRCS(C); Martin A. Adson, MD; Archie H. Baggenstoss, MD
Arch Surg. 1977;112(4):451-456. doi:10.1001/archsurg.1977.01370040103016.
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• Over a 22-year span, 87 patients with carcinoma of the papilla of Vater underwent radical pancreatoduodenectomy. No patient was lost to follow-up, and extended observation was possible in most cases: the definitive operation was at least five years earlier than this study in 87% and at least ten years earlier in 73%. Operative mortality was 11.5% among patients who had a single definitive operative procedure and 15.4% among those whose treatment involved reoperation after prior exploration elsewhere. Overall survival rates at two, five, and ten years were 56%, 34%, and 20%, respectively. Factors associated with favorable survival were histologic differentiation (Broders grades 1 and 2), absence of nodal metastasis, and papillary histologic characteristics. Noteworthy is the fact that no patient having resection of an undifferentiated carcinoma (Broders grade 3 or 4) survived four years.

(Arch Surg 112:451-456. 1977)


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