Curative resection for left-sided pancreatic malignancy.

BACKGROUND: Surgical technique in pancreatic cancer has seen significant developments, but much of the knowledge refers to pancreatic head carcinoma. Reports on the management of tumours of the body and tail have been less frequent. Current knowledge teaches that adenocarcinomas of the body and tail of the pancreas have a worse prognosis. The aim of this study is to report the short- and long-term outcome in 20 patients with left-sided pancreatic malignancy, where 'resection for cure' was done. PATIENTS AND METHODS: Retrospective study of demographic data, symptomatology, diagnostic methods, operative management, pathology report, postoperative morbidity and mortality.
RESULTS: Postoperative complications were seen in 40% of patients. One patient died on day 5 from sepsis with multiple organ failure. Other complications were intra-abdominal bleeding, bleeding from the gastroentero-anastomosis, postoperative jaundice, pleural exudate, wound dehiscence and intra-abdominal abscess. The patients with ductal adenocarcinoma had a median survival of 14 months and a 5-year survival of 17%. The median survival for the whole group of patients was 17 months and the 5-year survival was 23%. One patient with malignant insulinoma and two patients with adenocarcinoma had a survival exceeding 5 years (98, 174 and 183 months, respectively). DISCUSSION: Selected patients with left-sided pancreatic adenocarcinoma may be operated on with results similar to pancreaticoduodenectomy (Whipple procedure) for cancer of the pancreatic head regarding postoperative morbidity and mortality as well as long-term survival. Thus, although left-sided pancreatic cancer generally appears at a more advanced stage, it seems true that treatment results are similar if radical excision can be achieved.