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The management of patients suffering from chronic incurable organic disease combined with a strong element of psychiatric disorder requires patience. Sometimes the involved physicians reach their limits and are pushed to the brink of resignation.

Partial duodenopancreatectomy, which leads to poor long-term results in the treatment of cancer of the head of the pancreas, achieves 5 years survival rates of 30% in cancer of Vater's ampulla. A report is given on 3 patients, who could be cured of a cancer of Vater's ampulla by this procedure for more than 10 or 15 years respectively. The quality of life of these patients is satisfactory. As a late consequence diabetes mellitus occurred in 2 patients.

In the past few years psychosomatic medicine, apart from investigating the psychosocial sources of bodily disorders, has begun to focus also on the opposite side of the problem, the question of how people experience illness and cope with it. This "somatopsychic" view can be regarded as a supplement to the so far prevailing psychosomatic perspective and its approach. The present study describes and analyzes various strategies of coping with illness as observed in a group of pancreatectomized patients, a group of patients which has not been investigated before in this field of research. Based upon the experience of long-term psychotherapeutic care, the study differentiates between the more problematic and the more beneficial forms of coping, and empirically verifies their prevalence and adaptivity in a sample of pancreatectomized patients, not selected with regard to the extent of care needed. The findings are discussed from the methodological and the psychosomatic-psychotherapeutic point of view.