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Over a period of 29 years (1949--1977) a total of 50 extended gastroduodenopancreatectomies have been performed in 309 patients with cancer of the subhepatic region. The indication for this type of surgery was determined by: 20 malignant lesions of the head of the pancreas, 14 cancers of the Vater ampula, 10 neoplasies of the juxta-vaterian duodenal portion, and 6 stenosing malignant tumors of the terminal choledocus. The major operation, of long duration, employed in radical oncologic treatment, entailed 13 postoperative deaths (26%) and resulted in an average survival of 2 years. Eight of the patients were alive after a follow-up of 5 years. The Child procedure was used 32 times, the remaining cases being operated according to a personal technique, in two variants. The results of paleative interventions are discussed in parallel. These consisted in simple bilio-digestive derivations. Based on the authors personal experience, and considering the data published in the specialized literature it may be postulated that oncologic surgery, such as that applied in extended gastroduodenopancreatectomy is fully justified when general and intra-operative conditions allow such interventions. The results depend, to a large extent, on the early diagnosis of these cancers.

In a total number of 1,109 cases of gastric carcinomas (encountered between 1949 and 1973) the authors have noted 122 cases with oeso-gastric localization in which 29 total gastrectomies were performed and 50 superior polar resections with oeso-gastric anastomosis (the mortality in both groups of patients was of 20%).

The evolution is presented, of a partial infarction of the small bowel, of venous origin, without apparent cause. In the 10-th day after onset, following a segmentary resection of the jejunum and termino-terminal anastomosis, the patient had another segmentar infarction of the ileon, also of venous origin, that was cured after resection. After recovery the hematological investigations evidenced a coagulation disturbance that necessitated longterm heparin therapy, a treatment that is continued 3 years after surgery. Although the repeated infarction of the small bowel of venous origin is theoretically possible the case presented appears to be unique by its evolution and the result of the medico-surgical treatment.