Original paper
The role of palliative pancreatoduodenectomy in treatment of advanced pancreatic head tumours

Aim: Assessment of the role of palliative pancreatoduodenectomy in treatment of advanced pancreatic head tumors on the basis of comparison of results of treatment of pancreatic head tumors using palliative pancreatoduodenectomy (PDP) and palliative by-passes (PB). Material and methods: 40 patients were chosen for the study: (22 females and 18 males) with locally advanced pancreatic head tumor, who were treated in the clinic between January 2001 and December 2004. 18 persons were treated with PDP and 12 were treated with ZO. Results: Within the group of 18 patients who underwent PDP, 12 patients (66.8%) had reconstruction of alimentary canal with Traverso method, 6 cases (33%) with Whipple method. Within the second group (PB) was performed: only biliary in 4 cases (33%), biliary and digestive in 8 cases (66%). Average operating time in group of patients who had PDP was 2.8 hours, and in group who had PB 1.5 hours. Post-operation after-effects occurred in 38.8% of patients after PDP and 33.3% after PB. Relaparotomy was performed in 5 cases (27.7%) after PDP and 2 cases (16.6%) after PB. In the group of patients who underwent PDP In post-operation period 2 patients died (11.1%)and after PB 3 patients (25%) died. Conclusions: Results of operational treatment of advanced pancreatic head tumor using PDP and PB are comparable. Patients with advanced cancer/neoplastic processes in pancreas’s head have better chance to survive after PDP than after PB.