Postoperative Complications Following 122 Pancreaticoduodenectomies

Moon, Hyoun Jong; Sohn, Tae Sung; Noh, Jae Hyung; Choi, Seong Ho; Joh, Jae Won; Kim, Yong Il

Abstract

BACKGROUND: A pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancer. Because of the improvement in the postoperative mortality and morbidity over the past several decades, the indications for pancreaticoduodenectomy are becoming more extended. The aim of this study was to determine the incidence, the origin, and the present management strategy for early and late complications following this operation.
METHODS
In one hundred twenty-two patients who had undergone a pancreaticoduodenectomy for periampullary cancer, mid bile-duct cancer, and other benign or malignant diseases during the period from Oct. 1994 to Dec. 1997 postoperative complications and operative mortality were analyzed retrospectively.
RESULTS
Thirty-nine patients were treated for common bile-duct cancer, 37 patients for cancer, 22 patients for ampulla of Vater cancer, 5 patients for duodenal cancer, 4 patients for advanced gastric cancer, 2 patients for gall bladder cancer, and 13 patients for benign diseases or traumatic injury of the pancreas. A standard pancreaticoduodenectomy was performed in 92 patients, a pylorus-preserving pancreaticoduodenectomy in 12 patients, a total pancreatectomy in 11 patients, and a hepatopancreaticoduodenectomy in 7 patients. Of all the patients, 6 patients were treated with a pancreticoduodenectomy with combined portal vein resection. There was one hospital death. Postoperative complications occurred in 66 patients, and 24 patients had more than one. In 10 patients with complications, reoperative treatment was performed. The remaining 56 patients underwent the conservative treatments.
CONCLUSIONS
The pancreaticoduodenectomy remains a formidable procedure despite the low mortality rate reported recently. Postoperative complications following a pancreaticoduodenectomy are common and their prompt recognition and appropriate management are of great importance in contributing to a successful outcome for the majority of patients.