Cancer of the pancreas: Palliative operation, Whipple procedure, or total pancreatectomy

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Abstract
Current reviews of the treatment of cancer of the pancreas, most of which evaluate cases treated in the past one or two decades, continue to present discouraging results. The advantages and disadvantages of performing a resection must be carefully evaluated for each patient. The dilemma of resection should be discussed with the patient before operation and when capable he or she should influence the decisions the surgeon anticipates facing during the operation. Pancreatoduodenectomy is the treatment of choice for carefully selected cases of carcinoma of the head of the pancreas and other periampullary carcinomas. Total pancreatectomy has not, at this point, been shown to provide sufficient advantages to warrant routine adoption as the treatment of choice when resection is to be performed.