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[Surgical treatment of pancreatic adenocarcinoma by cephalic duodenopancreatectomy (Part 1). Post-surgical complications in 204 cases in a reference hospital].

Authors :
Busquets J
Fabregat J
Jorba R
Peláez N
García-Borobia F
Masuet C
Valls C
Martínez-Carnicero L
Lladó L
Torras J
Source :
Cirugia espanola [Cir Esp] 2010 Nov; Vol. 88 (5), pp. 299-307.
Publication Year :
2010

Abstract

Introduction: Cephalic duodenopancreatectomy (CDP) is the treatment of choice in cancer of the head of the pancreas. However, it continues to have a high post-surgical morbidity and mortality. The aim of this article is to define variables that influence post-surgical morbidity and mortality after cephalic duodenopancreatectomy due to pancreatic adenocarcinoma (PA) cancer of the head of the pancreas (CHP).<br />Material and Methods: The variables were prospectively collected form patients operated on between 1991 and 2007, in order to investigate the factors of higher morbidity.<br />Results: A total of 204 patients had been intervened due to PA, of whom 57 were older than 70 years. Of these patients, 119 had a CPD, 11 extended lymphadenectomy, 66 with pyloric conservation, and 8 with extension to total pancreatectomy due to involvement of the section margin. Portal or mesenteric vein resection was included in 35 cases. Post-surgical complications were detected in 45% of cases, the most frequent being: slow gastric emptying (20%), surgical wound infection (17%), pancreatic fistula (10%), and serious medical complications (8%). Further surgery was required in 13%, and the over post-surgical mortality was 7%. A patient age greater than 70 years, post-surgical haemoperitoneum, gastroenteric dehiscence, and the presence of medical complications were post-surgical mortality risk factors in the multivariate analysis. Pancreatic fistula was not a factor associated with post-surgical mortality.<br />Conclusions: Cephalic duodenopancreatectomy is a safe technique but with a considerable morbidity. Patients over 70 years of age must be carefully selected before considering surgery. Serious medical complications must be treated aggressively to avoid an unfavourable progression.<br /> (Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.)

Details

Language :
Spanish; Castilian
ISSN :
1578-147X
Volume :
88
Issue :
5
Database :
MEDLINE
Journal :
Cirugia espanola
Publication Type :
Academic Journal
Accession number :
20663494
Full Text :
https://doi.org/10.1016/j.ciresp.2010.05.006