Toward zero pancreatic fistula after pancreaticoduodenectomy with pancreaticogastrostomy.
BACKGROUND
Postoperative morbidity after pancreaticoduodenectomy has been associated mainly with the development of pancreatic fistula. However, postoperative complications unrelated to pancreatic fistula cannot be disregarded after pancreaticoduodenectomy. The aim of the present study was to investigate the postoperative morbidity in a large series of pancreaticoduodenectomies with pancreaticogastrostomies without pancreatic fistula.


METHODS
The present study analyzed the data from 194 consecutive patients undergoing a pancreaticoduodenectomy with a pancreaticogastrostomy between July 1997 and June 2003 in whom no postoperative pancreatic fistula occurred.


RESULTS
The overall rate of postoperative morbidity was 33.5%. Specific and general complications occurred in 16% and 17.5% of the patients, respectively. An American Society of Anesthesiologists (ASA) score of 3 and blood transfusion were the only independent factors associated with postoperative morbidity.


CONCLUSIONS
Our study found that the overall morbidity after a pancreaticoduodenectomy with a pancreaticogastrostomy still remains high even in the absence of pancreatic fistula and is associated with the preoperative medical condition (ASA score) of the patients and with blood transfusion.
Rosso
Edoardo
E
Centre de Chirurgie Viscérale et de Transplantation, Hautepierre Hospital, Hôpitaux Universitaires de Strasbourg, Louis-Pasteur University, Avenue Moliere, 67200, Strasbourg, France.
Bachellier
Philippe
P
Oussoultzoglou
Elie
E
Scurtu
Radu
R
Meyer
Nicolas
N
Nakano
Hiroshi
H
Verasay
Guillermo
G
Jaeck
Daniel
D
D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005763:Gastroenterostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D010185:Pancreatic Fistula / Q000453:epidemiology* / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome