Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients.
Pancreaticoduodenectomy (PD) is still a difficult procedure with significant morbidity. We report 150 consecutive PDs performed during a 3-year period. All the cases have been prospectively evaluated with regard to the surgical outcome. Mortality in this series was 3/150 (2%) with a re-operation rate of 5/150 (3.3%); surgical complications were experienced in 57/150 (38%). The most frequent complications were collections in 25/150 (16.6%) and pancreatic fistulas in 16/150 (10.7%). The majority of these complications were conservatively managed: only one abscess and one fistula due to an anastomotic dehiscence required re-operation. The complication most responsible for mortality was haemorrhage secondary to arterial pseudoaneurysms in patients with severe post-operative pancreatitis. The continued high morbidity of PDs is compensated by the ability to treat complications non-operatively, resulting in a surgical risk that should now be considered medium to low in high volume centres.
Bassi
C
C
Surgical and Gastroenterological Department, Endocrine and Pancreatic Unit, University of Verona, Hospital G.B. Rossi, Verona, Italy. Claudio.Bassi@univr.it
Falconi
M
M
Salvia
R
R
Mascetta
G
G
Molinari
E
E
Pederzoli
P
P
D000208:Acute Disease; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply; D010182:Pancreatic Diseases / Q000601:surgery*; D010185:Pancreatic Fistula / Q000209:etiology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D010195:Pancreatitis / Q000209:etiology