Distal pancreatectomy for cancer: results in U.S. Department of Veterans Affairs hospitals, 1987-1991.

Although cancers of the pancreatic body and tail are often advanced at the time of diagnosis, resection of localized tumors can result in long-term survival. A search of the computerized records of the U.S. Department of Veterans Affairs (DVA) revealed 29 distal pancreatectomies performed for pancreatic cancer from 1987 to 1991. Operative complications and survival data were available on all patients, and pathologic and staging information were retrieved on 21 patients, seven of whom had cancers other than pancreatic adenocarcinoma. Although 30-day mortality was high after distal pancreatectomy (21%), mean survival exceeded 1 year for patients with localized pancreatic adenocarcinoma and for those with histologies other than pancreatic cancer. Surgical resection should be offered to patients with lesions of the pancreatic body and tail when metastases are not demonstrated; survival will likely be prolonged when nodal or systemic metastases are absent. These recent DVA results from a wide variety of surgeons, hospital sizes, and university affiliations may more closely reflect the national experience with this operation in patients with cancer than do single institutional reports.