Complications of pancreatic cancer resection.
Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20% but is around 6% or less in specialist centres. The overall complication rate even in specialist centres is 18-54%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4% for fistula, 9.9% for delayed gastric emptying, 4.8% for bleeding, 4.8% for wound infection and 3.8% for intra-abdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9% with a mortality rate of 23 to 67%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.
Halloran
C M
CM
Department of Surgery, Royal Liverpool University Hospital, UK.
Ghaneh
P
P
Bosonnet
L
L
Hartley
M N
MN
Sutton
R
R
Neoptolemos
J P
JP
D000714:Anastomosis, Surgical; D005746:Gastric Emptying; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007902:Length of Stay; D015282:Octreotide / Q000627:therapeutic use; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D015282:Octreotide