Experience with 21 pancreaticoduodenectomies.

Twenty-one patients underwent pancreaticoduodenectomy-19 for neoplasia and two for benign disease (operative mortality, 9.5%). Anastomotic leakage occurred in three patients (14.3%); in two it was biliary and in one it was pancreatic. Vagotomy was not employed and there were no instances of stomal ulceration. Four patients (21%) operated on for malignant neoplasm are free of disease from five to ten years since surgery, and two more are in good health for less than five years (total, 31.6%). The presence of an involved regional lymph node is not a contraindication to curative or palliative resection in either carcinoma of the ampulla of Vater or carcinoma of the pancreas.