XXXX and periampullary region: palliation versus cure.

@entity1 @entity135 @entity788 @entity1087 @entity548 @entity5 @entity189 @entity260
A retrospective study of 310 @entity1 with @entity189 of the head of the pancreas or periampullary region was performed. Preoperative bile drainage by placement of a stent reduced the number of @entity260 , especially @entity548 (P = 0.03). The operative mortality rate was nil in @entity1 with @entity5 aged under 70 years and 23 per cent in those over 70 years of age (P < 0.001). In the last 2 years of the study, the mortality rate following resection decreased to 2 per cent. @entity5 -containing resection margins did not influence survival after resection (P = 0.48). @entity5 dimension of @entity788 and the presence of @entity5 in locoregional lymph nodes (N1a) resected with the primary @entity5 in @entity135 were of no prognostic value. Following palliative resection of @entity189 of the pancreatic head, median survival was significantly better than when no resection was performed (10.1 versus 3.9 months, P < 0.001). In conclusion, even palliative resection may benefit some @entity1 . Preoperative bile drainage is indicated in those with @entity1087 . Resection should be performed, irrespective of @entity5 size, provided that the unit's operative mortality rate is sufficiently low.
