Results of Total Pancreatectomy for Adenocarcinoma of the Pancreas

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Abstract
ALTHOUGH THERE have been substantial improvements in morbidity and mortality for surgical resection of cancer of the pancreas, improvements in survival have been small,1-4 with the majority of patients dying in less than 2 years after "curative resection."5 A number of adverse prognostic factors have been identified, including lymph node status, tumors with poor histologic differentiation, and tumor size.6 While the extent of operation has not been shown to be a significant predictor of outcome, some have suggested that pancreatic adenocarcinoma is a multicentric disease and resections less than total are suboptimal. Thus, the concept of total pancreatectomy with wide regional lymphadenectomy is intellectually appealing.