Curatively intended surgery for exocrine pancreatic cancer.

Resective surgery for exocrine pancreatic cancer can currently be performed with little or no hospital mortality. The operation is most often performed as a Whipple resection, but several modifications (e.g., subtotal pancreatectomy) have been advocated. The pylorus-preserving modification has gained in popularity, although its ability to remove all lymph nodes has been questioned. Total pancreatectomy, always causing brittle diabetes, is performed in less than 10% of patients, and then more and more often as part of an extended operation, including major vessels, which must be substituted. Adjuvant treatment with impact on long-term survival is lacking; however, the results of curatively intended surgery for exocrine pancreatic cancer is slowly getting better.