RADICAL RESECTION OF HEAD OF PANCREAS AND TOTAL PANCREATECTOMY

Exactly fifty years ago the first recorded successful attempt was made to remove a carcinoma of the ampulla of Vater by radical resection. After this operation by Halsted¹ only sporadic attempts at radical resection were made, most of them being unsuccessful. Then, in 1935, Whipple. Parsons and Mullins² devised a technic for operation in two stages which could be undertaken as a curative and not a palliative measure. The advent of vitamin K permitted one stage radical resection to be executed with less risk than had accompanied certain palliative procedures before this means of correction of deficiency of prothrombin was available. The important observations made by Dragstedt³ concerning the physiology of the pancreas and the surgical accomplishments of Brunschwig,⁴ Crile,⁵ Trimble and his associates,⁶ Hunt.⁷ Pearse,⁸ Cattell,⁹ Orr¹⁰ and others soon gave the members of the profession confidence in the