RT Journal
A1 Fong Y
T1 CHanges in morbidity after pancreatic resection—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2003
FD December 1
VO 138
IS 12
SP 1315
OP 1315
DO 10.1001/archsurg.138.12.1315
UL http://dx.doi.org/10.1001/archsurg.138.12.1315
AB 
The past 2 decades have seen tremendous improvements and refinements in pancreatic resections. The article in this issue of the ARCHIVES by Büchler and colleagues is a remarkable documentation of 617 pancreatectomies performed by a single group and echoes the results currently seen in many major centers. The pancreatoduodenectomy is now performed in a few hours at most major hospitals, with operative mortalities less than 4% and with most patients returning to normal function. Because pancreatectomy represents the only curative therapy for pancreatic adenocarcinoma, improvement in perioperative outcome is a first step toward effective treatment of this disease. However, the long-term outcome for pancreatic adenocarcinoma is still extremely poor. The actuarial 5-year survival in most major series is less than 20%, and even at major centers, there are few actual 5-year, disease-free survivors.1- 3 Thus, the surgical procedure has prolonged survival but has had little effect on long-term outcome for most of the 30 000 patients each year treated for adenocarcinoma of the pancreas.