Cancer of the head of the pancreas and choledochoduodenal junction: a clinical study of 88 Whipple resections.

The results of 88 pancreaticoduodenectomies performed at one institution over a period of 15 years (1960-1974) have been reviewed. Resection was undertaken in 62 patients with carcinoma of the head of the pancreas (HP) and in 26 patients with carcinoma of the choledochoduodenal junction (CDJ), with an operative mortality of 10% and 15% respectively. The 5-year survival rate for patients without positive lymph node histology was 13% for those with HP carcinoma and 21% for those with CDJ carcinoma. With positive nodes, the 5-year survival rates were 3% and 33% respectively, which suggests that a Whipple resection in patients with CDJ carcinoma has a relatively favourable prognosis even in the presence of lymph node metastases. In patients with HP carcinoma, on the other hand, resection was associated with a poor prognosis.