Observations on Some Metabolic Changes After Total Pancreatoduodenectomy

Fallis, Laurence S.; Szilagyi, D. Emerick

doi:10.1097/00000658-194810000-00002

Cited by 46 publications

(3 citation statements)

References 5 publications

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“…Whether this was the first ever performed will probably never be determined. Praderi reported that Fallis and Szilagyi performed a successful total pancreaticoduodenectomy for cancer in 1944 as well [13,78]. We also note that Mayo-Robson reported a case performed by Billroth in 1894 only to be subsequently discounted by Sauv6 in his extensive review of pancreatic surgery published in 1908 [53].…”

Section: I I May 54mentioning

confidence: 78%

Harbinger or hermit? Pancreatic anatomy and surgery through the Ages—Part 2

McClusky¹,

Skandalakis²,

Colborn³

et al. 2002

World j. surg.

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Section: I I May 54mentioning

confidence: 78%

Harbinger or hermit? Pancreatic anatomy and surgery through the Ages—Part 2

McClusky¹,

Skandalakis²,

Colborn³

et al. 2002

World j. surg.

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“…Rockey [34] is usually credited with the first total pancreatectomy for carcinoma, although the patient died 15 days after resection. Priestley et al [35] then performed a successful total pancreatectomy for hyperinsulinism, and Fallis and Szilagyi [36], in 1948, reported the first successful total pancreatectomy for carcinoma of the head of the pancreas.…”

Section: Total Pancreatectomymentioning

confidence: 99%

Development and Progress in Resective Surgery for Pancreatic Cancer

Howard

1999

World j. surg.

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Pancreatoduodenectomy was developed from experience gained with transduodenal ampullectomy, preceded by a relatively bloodless cholecystoenterostomy. Although Codivilla (1898) and Kausch (1909) each achieved a single survivor following pancreatoduodenectomy, further development of the operation had to await discovery of vitamin K and a description of human blood types, the latter leading to the development of blood banks. After vitamin K and blood banks became available, Allen O. Whipple and his resident C.R. Mullins developed the two-stage pancreatoduodenectomy (1934-1935) and Whipple the one-stage procedure (1940). Although the mortality rate from pancreatoduodenectomy remained approximately 33% for more than 25 after Whipple's reports, concentration of resection in "centers of specialization" has now reduced mortality rates below 5%. Thus operative survival has been achieved, but long-term survival has not kept pace. Long-term data remain inadequate because they are usually expressed as Kaplan-Meier estimates and because of the nonuniformity of reporting (e.g., exclusion of postoperative deaths and palliative resections, intraoperative adjuvant therapies, and variations of operative techniques). Widely based Kaplan-Meier estimates of 5-year survival range from 12% to 15% after resection and more than 20% in selected categories. Total pancreatectomy has not improved short- or long-term survival rates. Extended lymphadenectomy and resection of peripancreatic soft tissues, as currently developed in several surgical clinics in Japan, suggest a higher incidence of complications but perhaps more long-term survivors. Interpretation of their data is currently subject to the same limitations noted above. As our surgical forebears needed vitamin K and blood banks to achieve postresection survival, we and our students need effective adjuvant therapy of micrometastases and better modalities for early diagnosis to improve long-term survival.

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“…A successful total pancreatectomy for carcinoma of the pancreas was carried out by Fallis and Szilagyi in 1944 21. The patient, a 44‐year‐old man, survived for 14 months after the operation for carcinoma of the head of the pancreas and died of recurrent cancer.…”

Section: History Of Carcinoma Of the Pancreasmentioning

confidence: 99%

Historical survey of carcinoma of the pancreas

Tsuchiya¹,

Fujisawa²

1999

Journal of Hepato-Biliary-Pancreatic Surgery

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The ancient Egyptians probably recognized cancerous lesions on the surface of the body. Hippocrates described cancers of the skin, larynx, breast, inguinal region, uterus, and vagina. For centuries, the treatments were excision, cauterization, ointment application, and fomentation. The development of anesthesia, antisepsis, and disinfection, and the discoveries of X-rays and radium in the nineteenth century, have greatly promoted advances in surgery in the twentieth century. At the beginning of this century, it became possible for surgeons to extirpate tumors from previously inaccessible body interiors, and today surgeons are able to remove affected organ systems and even entire regions of the body with safety because of advances in physiology, anesthesia, transfusion, and anti-infective agents. The surgical results for most gastrointestinal cancers have improved markedly in recent years, only with pancreatic cancer showing no improvement in results. Drastic extensive surgery has not led to better results. A small carcinoma less than 1 cm in diameter may not always be an early carcinoma. Early cancer in duct cell carcinoma may be one localized in the mucous membrane of the pancreatic duct. There is now an expectation that early diagnosis will be possible by using magnetic resonance cholangiopancreatography and cytological diagnosis of the pancreatic juice.

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Observations on Some Metabolic Changes After Total Pancreatoduodenectomy

Cited by 46 publications

References 5 publications

Harbinger or hermit? Pancreatic anatomy and surgery through the Ages—Part 2

Harbinger or hermit? Pancreatic anatomy and surgery through the Ages—Part 2

Development and Progress in Resective Surgery for Pancreatic Cancer

Historical survey of carcinoma of the pancreas

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