Solid and papillary neoplasm of the pancreas. Emphasis on surgical treatment
L. B. Jeng, M. F. Chen and R. P. Tang
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Six Chinese females with solid and papillary neoplasms of the pancreas
underwent surgery. Mean age was 26 years. The most common clinical sign was
a large palpable abdominal mass. One patient presented with shock and acute
onset of abdominal pain with positive peritoneal signs due to rupture of
the tumor. The surgical procedures included Whipple's operation in one
patient with a tumor at the head of pancreas, a 75% distal pancreatectomy
in two patients with tumor of the body or tail of the pancreas, a partial
pancreatectomy and pancreaticogastrostomy in one patient with a tumor at
the neck and body of the pancreas, total excision in one patient with a
tumor of the body of the pancreas, and a Roux-en-Y cystojejunostomy in one
patient with a huge unresectable tumor of the head and body of the
pancreas. During the follow-up period of from 40 to 83 months, four
patients had survived and two had died of causes unrelated to the tumor in
the differential diagnosis of a pancreatic mass, especially in young women
with long histories of epigastric masses. Resection is the treatment of
choice when the tumor is resectable. For unresectable tumors, a bypass
procedure might be an alternative.
