Successful Resection of the Head of the Pancreas for Carcinoma
Until 1935 when Whipple, Parsons, and Mullins1 described the radical two-stage operation for carcinoma of the ampulla of Vater, the surgical treatment of carcinomas in the region of the head of the pancreas had met with consistent failure Later, in April, 1938, Whipple2 collected 11 cases in which resections of the head of the pancreas had been performed for carcinoma. One additional case3 has been reported, but only six of these 12 patients have survived the operation.
In the case reported here, the patient was suffering from a carcinoma of the head of the pancreas and has made a satisfactory convalescence following radical resection of the head of the pancreas and duodenum.
Report of Case
The patient was a man, 37 years of age, whose chief complaint was jaundice. Five months before entry, he had noticed sluggishness, nervousness, and easy fatigability. This was followed in two months by painless jaundice associated with marked pruritis. Thirty pounds in weight had been lost.
Examination showed deep jaundice, a smooth, firm enlargement of the liver extending two fingers’ breadth beneath the costal margins, and a large tense rounded mass in the region of the gallbladder.
The icterus index was 100 units and the coagulation time of the blood was one hour. The blood phosphatase was 6.6 units. Roentgen examination of the duodenum showed no evidences of a tumor in the region of the ampulla of Vater. A plain film of the gallbladder region failed to demonstrate any opaque biliary calculi. There was a. . .