Management of pancreatic cancer in Hong Kong

Abstract

Between October 1983 and October 1995, 176 patients (113 males and 63 females) with pancreatic cancers were managed at the Department of Surgery, the University of Hong Kong at Queen Mary Hospital. Their mean age (± SEM) was 66 ± 1 years. One hundred and fifty-two patients (86.4%) had tumours located in the head of the pancreas. Pancreaticoduodenectomy was performed in 20 patients (13%). Seven patients were 70 years old or over at the time of surgery. Nine patients developed complications and there were two hospital deaths. The use of pre-operative biliary drainage in five patients had no effect on the postoperative outcome. There was no correlation between a history of abdominal pain and the presence of perineural invasion in the resected specimen. The median and five-year survival rates after pancreaticoduodenectomy were 26.8 months and 20.5%, respectively. Seventy-nine patients underwent a range of palliative operations, the most common operation being gastrojejunostomy with choledochojejunostomy (50). The overall median survival after palliative surgery was 5.6 months. Fifty-three patients were managed conservatively and of these, 35 were offered biliary stenting by either the endoscopic (19) or the percutaneous (16) route. The overall median survival times of patients with carcinoma of the body (19) and the tail (5) of the pancreas were 3.3 months and 4.6 months, respectively.