It is only in the past ten years that patients with carcinoma of the head of the pancreas have been offered a possibility of cure by surgical excision of the head of the pancreas and duodenum. The high mortality rate that at first attended this extensive procedure has been lowered by the discovery of vitamin K and by technical improvements in anastomosing the pancreatic and biliary ducts to the intestine. Mortality rates for large series of radical resections of the pancreas as low as 20 per cent have been reported,1 a figure which corresponds favorably with that attending radical resections of gastric or intestinal carcinomas fifteen years ago.
Although the curability rate of carcinoma of the pancreas is still low the palliation afforded by radical resection with implantation of the common bile duct and the pancreatic ducts into the intestinal tract renders the operation well worth-while to those patients whose tumor has not extended beyond the pancreas. Not only do these patients have the nutritional advantage of the draining of both bile and the external secretion of the pancreas into the intestinal tract, but they have the knowledge that the tumor has been removed and that they have a chance for permanent cure. This attitude is to be compared with the hopelessness of the patient who is subjected to an exploratory operation and learns that he has an incurable cancer and can do nothing but await the inevitable end.
Cancer of the head of the pancreas is in general no. . .