Analysis of Risk Factor for Major Complications after Pancreatoduodenectomy

Kim, Eun Young; Park, Seong Heum; Park, Sei Hyeog; Choi, Kyung Woo

Abstract

BACKGROUND/AIMS: The mortality after pancretoduodenenctomy is decreased to less than 5 % in centers with experience. The morbidity, however, still remains high although the decrease has also been demonstrated. The aim of this study was to identify risk factors responsible for major complications following pancreatoduodenectomy.
METHODS
Various features of forty nine consecutive patients who underwent pancreatoduodenectomy from 1990 to 1999 were statistically analyzed to determine risk factors for major postoperative complications. Anastomotic leakages, intraabdominal hemorrhage and intraabdominal abcess were categorized as major postoperative complication.
RESULTS
In our series, postoperative mortality and morbidy rate were 6.1% and 51.0%, respectively. Seventeen major complications were found in 14 patients(28.6%): 7 cases with pancreaticojejuostomy leakage, 4 cases with biliojejunostomy leakage, 3 cases with intraabdominal hemorrhage and 1 case with intraabdominal abcess. The statistical analysis revealed that episode of intraoperative hypotension was the only independent risk factor for major postoperative complication.(Odds ratio: 25.4849, p=0.0048)
CONCLUSION
Careful intraoperative management for maintenance of adequate blood pressure in hemodynamically unstable patients is important to reduce major complications after pancreatoduodenectomy.