Thank you for the opportunity to respond to the letter from Professor Huguier. I am most appreciative of Professor Huguier's interest in my commentary, which analyzed current data regarding the efficacy of surgical excision and adjunctive therapy for adenocarcinoma of the pancreas, and suggested the necessity for a change in our perceptions of the precise value of current therapy. In that commentary, I took the position that all resections for pancreatic adenocarcinoma were essentially palliative: eventual recurrence was the rule and not the exception. Because of the studies cited in the article, however, I also concluded that pancreatoduodenectomy for pancreatic adenocarcinoma, although not curative, had considerable palliative value because survival following this procedure had been demonstrated to be significantly longer than with bypass surgery.
Bradley EL. Improving the Results of Pancreatoduodenectomy—Reply. Arch Surg. 2002;137(12):1447. doi: