The role of surgery in the treatment of carcinoma of the pancreatic head.

Surgery in pancreatic carcinoma has changed within the last two decades. One of two patients nowadays can be treated without operation. Palliative surgical procedures rarely have to be done. Actually jaundice in patients with unresectable pancreatic cancer is treated by stenting instead of performing the classic biliodigestive anastomosis. In our department the rate of patients suitable for radical surgery lays constantly between 20 and 25% within the last decades. However, this high percentage of potentially curable patients may be due to a "positive patient selection" referred to a University hospital. In accordance with international publications it seems to be certain, that surgical therapy for pancreatic cancer has reached its limitations. Due to these open questions, working on pancreatic cancer will remain one of the most challenging but worthwhile features for generations of surgeons. (Tab. 4, Fig. 7, Ref. 16).