[Is extended lymphadenectomy justified in surgery for pancreatic adenocarcinoma? Apropos of a series of 59 cases]

Abstract

Between October 1987 and December 1992, we reviewed 130 medical records of pancreatic surgery for various pathologies, of which 57 cases had undergone cephalic duodenal pancreatectomy (C.D.P.) for pancreatic adenocarcinoma. There were 32 classical C.D.P. without lymphadenectomy and 25 C.D.P. with widened lymphadenectomy as practised by the Japanese workers Ishikawa, Manabe, and by others. Operatory mortality was 7% in both groups. On the other hand, morbidity was higher with widened lymphadenectomy and gave specific complications. Despite our short follow-up, it seems that the additional lymphatic excision does not significantly improve the rate of relapse or mortality. We have therefore stopped using the technique and have switched to per-operatory irradiation after tumoral excision.