Extended radical whipple resection for cancer of the pancreatic head: Operative procedure and results

Pancreatoduodenectomy is now the most fundamental operation for cancer of the pancreatic head. However, with the conventional operative procedure, the resection rate is low and long-term results are extremely poor. We introduced an extended radical Whipple operation in 1978 to improve surgical curability. Systemic dissection of extended lymph nodes and plexuses and en bloc resection of the portal vein was the basic concept. The resection rate for cancer of the pancreatic head has improved from 7-20 to 50%. The curative resection rate has also improved from 10 to 40-50%. The extended procedure did not increase the risk of the Whipple operation. When curative surgery was performed, good long-term survival was expected even in cases of extensive invasion to the portal vein. As a result, 11 patients who underwent curative surgery have survived for a long period of time. At present, however, the majority of patients are in an advanced stage at diagnosis and extended radical operation plays an important role in the curative therapy for this condition.