Pancreaticoduodenectomy for periampullary cancer: does the tumour entity influence perioperative morbidity and long-term outcome?. Issue 6 (2nd November 2018)

• Record Type: Journal Article
• Authors: Wiltberger, Georg; Krenzien, Felix; Atanasov, Georgi; Hau, Hans-Michael; Schmelzle, Moritz; Bartels, Michael; Benzing, Christian
• Is Part Of: Acta chirurgica belgica. Volume 118:Issue 6(2018)
• Page Start: 341
• Page End: 347
• Publication Date: 2018-11-02
• Subjects: Periampullary cancer -- complications -- pancreaticoduodenectomy; Surgery -- Periodicals; General Surgery; Chirurgie -- Périodiques; Surgery; Chirurgie (geneeskunde); Periodicals; Periodicals; 617.005
• DOI: 10.1080/00015458.2017.1385894
• Languages: English
• ISSNs: 0001-5458

Abstract

Abstract: Background: Malignant tumours of the periampullary region include ductal adenocarcinoma of the pancreas (Pan-Ca), distal bile duct cancer (DBDC) and adenocarcinoma of the ampulla (Amp-Ca). The present retrospective clinical study was designed to evaluate the influence of tumour entity on postoperative complications and identify risk factors predicting survival and morbidity. Methods: We retrospectively analysed data from all patients who underwent pancreatic resection for periampullary cancer with curative intent (R0 or R1). Demographic data, risk factors, perioperative complications and survival rates for the different subtypes were assessed. Results: A total of 225 patients with periampullary cancer were identified: 124 (55.1%) had Pan-Ca, 55 (24.4%) had DBDC and 46 had (20.4%) Amp-Ca. Sixty-nine patients (30.7%) had major complications (grade IIIb–V). Patients with DBDC had significantly more grade C pancreatic fistulas. Univariate analysis revealed male gender, BMI >30, R1-status, and low-grade tumour differentiation as risk factors for major complications. Overall in-hospital-mortality was 6.7%. Conclusions: Further research will be needed to implement more individualized therapy.