title: Pancreatoduodenectomy for periampullary tumors: a univariate and multivariate analysis of the parameters influencing the morbidity, mortality, and survival rates.
abstract: A total of 69 patients who underwent a pancreatoduodenectomy (PD) for a periampullary tumor in the Department of Surgery I, Kyushu University Hospital from January 1980 to December 1993 were analyzed in order to identify the parameters influencing the morbidity, mortality and survival rates. Anastomotic leakage was seen in 15 of the 69 patients; at the site of a pancreatojejunostomy in nine and at the site of a biliojejunostomy in six. A univariate analysis of complications based on 16 factors showed that major intraabdominal complications (anastomosis leakage and intrabdominal hemorrhage and abscess) were significantly affected by blood loss (> or = 1600 g vs < 1600 g, p < 0.05). Two of the 69 patients died within one month after PD, and the mortality rate was 3%. A univariate analysis of the survival rates of the 69 patients based on the 16 parameters showed that a history of jaundice, the serum level of albumin, and the nature of disease (i.e. malignant or benign) significantly influenced the survival rates (p < 0.05). The year of operation, the age of the patients, the serum level of total bilirubin, the operation time and the operative blood loss were not significant variants. A multivariate Cox regression analysis on these three profound factors showed that malignant disease significantly influenced the clinical course of patients with PD (p < 0.01). With proper patient selection and operative techniques, PD can thus be safely performed for a wide variety of diseases, in virtually any age group.
authors.affiliation: Department of Surgery I, Kyushu University, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: K
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: H
authors.initials: H
authors.lastname: Yamashita
authors.forename: Y
authors.initials: Y
authors.lastname: Ogawa
authors.forename: J
authors.initials: J
authors.lastname: Yoshida
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D018579:Patient Selection; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate