title: [Pancreatic and periampullary tumors: morbidity, mortality, functional results and long-term survival].
abstract: OBJECTIVE
  To evaluate postoperative morbidity and mortality, pancreatic function and long-term survival in patients with surgically treated pancreatic or periampullar tumours.
  
  
  METHODS
  Cohort study including 160 patients consecutively operated on: 80 pancreaticoduodenectomies (PD), 30 distal pancreatectomies (DP), 7 total pancreatectomies, 4 central pancreatic resections and 3 ampullectomies. The tumour was not resected in 36 patients. Pancreatic function was evaluated by oral glucose tolerance test, faecal fat excretion and elastase.
  
  
  RESULTS
  Resectability rate was 77.5%. In resected patients (n = 124), 38.7% had complications with a pancreatic fistula rate of 6.4% and a mortality rate of 4%. In PD, endocrine function worsened in 41% and 58.6% had steatorrhoea; these figures in DP were 53.6% and 21.7% respectively. In the 36 non-resected patients, postoperative morbidity was 27.7% and mortality 8.3%. Two and five-year survival rates in resected patients with pancreatic cancer were 42% and 9% respectively; in malignant ampulloma 71% and 53%; in mucinous adenocarcinomas 83% and 33%; in duodenal adenocarcinoma 100% and 75%; and in distal cholangiocarcinoma 50% and 50%.
  
  
  CONCLUSIONS
  Morbidity associated with resective pancreatic surgery is still high, but perioperative mortality is low. Endocrine and exocrine disturbances are very common depending on the type of resection. Despite the associated morbidity and functional disorders, surgery provides long-term survival in selected cases.
authors.affiliation: Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario de Valencia, Valencia, España. luis_sabater@hotmail.com
authors.forename: Luis
authors.initials: L
authors.lastname: Sabater
authors.forename: Julio
authors.initials: J
authors.lastname: Calvete
authors.forename: Luis
authors.initials: L
authors.lastname: Aparisi
authors.forename: Raul
authors.initials: R
authors.lastname: Cánovas
authors.forename: Elena
authors.initials: E
authors.lastname: Muñoz
authors.forename: Ramón
authors.initials: R
authors.lastname: Añón
authors.forename: Susana
authors.initials: S
authors.lastname: Roselló
authors.forename: Edith
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Bruno
authors.initials: B
authors.lastname: Camps
authors.forename: Raquel
authors.initials: R
authors.lastname: Alfonso
authors.forename: Carlos
authors.initials: C
authors.lastname: Sala
authors.forename: Juan
authors.initials: J
authors.lastname: Sastre
authors.forename: Andrés
authors.initials: A
authors.lastname: Cervantes
authors.forename: Salvador
authors.initials: S
authors.lastname: Lledó
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult