[Operative therapy of cancer of the head of the pancreas--determination of surgical status].

Therapy of ductal pancreatic carcinoma still remains a hardly resolved problem. In spite of the development of highly sensitive diagnostic methods 85 to 90% of the patients do not undergo therapy until they have already reached an incurable tumor stage. 5 years survival rate between 4 and 8% after potentially curative resections are rather depressing numbers. To patients with stages I and II duodenopancreatectomy as performed as subtotal pancreatectomy promises better mean survival and 5 years survival rates than bypass procedures only. When the tumor, however, infiltrates adjacent organs, resection might be limited to few selected cases. Substantial progress in the therapy of pancreatic carcinoma can be only expected from better understanding of the biological nature of the tumor, from earlier diagnosis and more precise selection of the patients as to the appropriate therapeutical alternatives.