Improving results of pancreaticoduodenectomy for pancreatic cancer.

This report from The Johns Hopkins Hospital reviews the results of pancreaticoduodenal resection during the decade of the 1990s, focusing on two recent publications. The first to be discussed involves a cohort of 650 consecutive patients undergoing pancreaticoduodenectomy (PD), with 443 patients having periampullary adenocarcinomas, 282 of whom had a pathologic diagnosis of pancreatic adenocarcinoma. The second report to be discussed involves the use of adjuvant chemoradiation therapy in a cohort of 174 patients who had successfully undergone PD for pancreatic adenocarcinoma. In both of these cohorts the operative mortality was less than 2%, and the median survival for resected pancreatic adenocarcinoma approximated 20 months.