Abstract
Thirteen patients with gastric carcinoma undergoing pancreaticoduodenectomy (PD group) in a recent one decade were subjected to a historical evaluation of the long term survival by radical operation. These cases were compared with 103 cases undergoing subtotal gastrectomy (non-PD group) for advanced carcinoma occupied lower third of the stomach in the same period. The five-year survival rates were 46% and 21% in PD-group and non-PD group, respectively. When the pancreas head was involved from the main tumor or metastatic lymph nodes, the 5-year survival rate was 53% in PD group, versus no survivors in non-PD group (p<0.05). Recurrence of lymph node metastasis occurred in 9% by Billroth I method, and 21% by Billroth II. For this, the prognosis was estimated in cases with positive lymph nodes of No.12, 13, 14 and 17 which were able to be dissected completely by PD, and resulted in the 2-year survival rates of 50% and 24% in PD and non-PD groups, respectively. These results suggest that PD for advanced carcinomas located in the lower third of the stomach may be recommended to the cases with invasion to the pancreas or metastasis to the lymph nodes around the pancreas head.
