Risk factors for complications after pancreatic head resection.
BACKGROUND
Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period.


METHODS
Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared.


RESULTS
Mortality was 3%. Overall and surgery-related complications occurred in 42% and 28%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [OR] 2.7), absence of preoperative biliary drainage (OR 1.9), and resection of other organs (OR 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period.


CONCLUSIONS
Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.
Adam
Ulrich
U
Department of Surgery, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany. ulrich.adam@chir.ukl-freiburg.de
Makowiec
Frank
F
Riediger
Hartwig
H
Schareck
Wolfgang D
WD
Benz
Stefan
S
Hopt
Ulrich T
UT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome