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April 1977

Radical Pancreatoduodenectomy for Cancer of the Papilla of Vater

Author Affiliations

From the Departments of Surgery (Drs Akwari, van Heerden, and Adson) and of Pathology and Anatomy (Dr Baggenstoss), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Arch Surg. 1977;112(4):451-456. doi:10.1001/archsurg.1977.01370040103016

• Over a 22-year span, 87 patients with carcinoma of the papilla of Vater underwent radical pancreatoduodenectomy. No patient was lost to follow-up, and extended observation was possible in most cases: the definitive operation was at least five years earlier than this study in 87% and at least ten years earlier in 73%. Operative mortality was 11.5% among patients who had a single definitive operative procedure and 15.4% among those whose treatment involved reoperation after prior exploration elsewhere. Overall survival rates at two, five, and ten years were 56%, 34%, and 20%, respectively. Factors associated with favorable survival were histologic differentiation (Broders grades 1 and 2), absence of nodal metastasis, and papillary histologic characteristics. Noteworthy is the fact that no patient having resection of an undifferentiated carcinoma (Broders grade 3 or 4) survived four years.

(Arch Surg 112:451-456. 1977)