Morbidity and mortality following multivisceral resections in complex hepatic and pancreatic surgery.
Complex multivisceral resections in major hepatic and pancreatic surgery are relatively infrequent, and information regarding the morbidity and mortality associated with such resections is scant. The purpose of this paper is to describe the outcomes following such aggressive surgical treatment. A retrospective review of the outcomes following multiorgan resection in the setting of major liver or pancreatic resection was conducted from 2002 until July 2006. Patients who had a major hepatic or pancreatic resection plus resection of at least one other organ were included. The primary outcome measures analyzed were the postoperative morbidity and mortality. Secondary outcomes included recurrence rates and survival. Twenty-seven patients met the inclusion criteria. There were two postoperative deaths (7%). Complications occurred in 59% of patients. Complications were minor in 26% and severe in 33%. Complications were more frequent in older patients and in patients with pancreatic resections. Mortality was significantly increased in the setting of a pancreaticoduodenectomy. These more aggressive procedures should be considered to carry a higher risk of complications, particularly in patients undergoing pancreaticoduodenectomies. Patients should be selected carefully when undertaking complex multivisceral resections in major hepatic and pancreatic surgery.
McKay
Andrew
A
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Sutherland
Francis R
FR
Bathe
Oliver F
OF
Dixon
Elijah
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
J Am Coll Surg. 2002 May;194(5):568-77
12025834
Br J Surg. 1997 Dec;84(12):1731-6
9448628
Lancet. 1996 Apr 13;347(9007):995-9
8606613
J Am Coll Surg. 2003 Aug;197(2):233-41; discussion 241-2
12892803
Dig Surg. 2002;19(4):281-5
12207071
J Am Coll Surg. 2002 Aug;195(2):196-202
12168966
Br J Cancer. 1999 Mar;79(9-10):1522-30
10188901
J Gastrointest Surg. 2002 Mar-Apr;6(2):147-57; discussion 157-8
11992799
Ann Surg. 2006 Jan;243(1):1-7
16371728
Surgery. 2004 Sep;136(3):650-9
15349115
Lancet. 1995 Mar 25;345(8952):745-8
7891484
Ann Surg Oncol. 2007 Jan;14(1):195-201
17080238
Ann Surg. 2006 Mar;243(3):364-72
16495702
J Am Coll Surg. 2004 Apr;198(4):570-6
15051011
Dis Colon Rectum. 2004 Aug;47(8):1310-6
15484344
Ann Surg Oncol. 2007 Mar;14(3):1143-50
17200913
Br J Surg. 2003 Aug;90(8):956-62
12905548
Ann Surg. 2004 Aug;240(2):205-13
15273542
Jpn J Clin Oncol. 2000 Jan;30(1):7-11
10770561
J Surg Oncol. 2005 May 1;90(2):95-100
15844189