Legal and ethico - medical implications in communication of the pancreatic cancer diagnosis
Legal and ethico - medical implications in communication of the pancreatic cancer diagnosis

Summary/Abstract: Pancreatoduodenectomy is a major and complex surgical intervention, addressed to selected cases of pancreatic head cancer, in which it is the only chance for cure. The operation is by itself associated with important morbidity and mortality. This is way choosing this intervention in the treatment strategy raises several problems, and some ethical issues. Material and methods: 44 patients with pancreatoduodenectomy were included in study. They were operated in the same period of 3 years (2005-2008), in two centers with a relatively small volume of pancreatic resections. The first group consists of 32 patients operated in Romania (Central Military Hospital, Bucharest), with a pancreatogastroanastomosis and the second group – 12 patients operated in France (CH Chambéry), with pancreaticojejunoanastomosis. A number of pre-operative parameters were recorded and then it was studied the relation with the morbidity and mortality. Results: the morbidity rate for all 44 patients was 65,90% and the mortality was 6,81%. All deaths happened in patients from the first group, 2 of the 3 cases being initially diagnosed with pancreatic cancer, while the pathologic findings showed chronic pancreatitis. For the second group, the overall morbidity exceeded 100%. After excluding the minor complications, the morbidity was 86,36%. Conclusions: the age of the patients and their economical status should not interfere the access for curative treatment; although the morbidity and mortality are greater in centers with relatively small volume of pancreatic resections, these can be done safely; the diagnosis must be as accurate as possible, in order to avoid performing a major surgical intervention for a benign condition, which can be treated in other way; the patients must be encouraged to seek surgical treatment.

• Details
• Contents