title: Pancreatoduodenectomy for pancreatic cancer in a low volume institution.
abstract: OBJECTIVE
  To report the patient morbidity and mortality rates following pancreatoduodenectomy (PD) carried out in our low volume institution, and compare our results with results from other high volume institutions.
  
  
  METHODS
  A retrospective analysis was conducted on patients with pancreatic malignancies surgically treated with PD from 2005 to 2010 in our institution. Data were collected with particular emphasis on morbidity and mortality rates. All patients were followed from the date of discharge to the date of death or status at the last follow-up (July 2011).
  
  
  RESULTS
  In a period of 5 years 42 patients underwent PD. Morbidity rates were as follows: 11.9% wound infections, 21.4% pancreatic fistulae, 23.8% delayed gastric emptying (DGE), 14.3% hemorrhage, and 7.1% biliary leak. Two patients required re-laparotomy one for delayed hemorrhage and one for sepsis. The mortality rate was 7.1%. The 2-year survival rate was 45.17 percent; and the median survival 22 months.
  
  
  CONCLUSIONS
  PD in our low volume institution had high morbidity and mortality rates compared with results published in the literature. There is a need, however, to establish a policy for referral of patients with pancreatic cancer to other centers with a higher number of resections, in order to decrease morbidity and mortality rates.
authors: Tzaneio General Hospital, First Surgical Department, Piraeus, Greece. pav.lampropoulos@gmail.com
authors: P
authors: P
authors: Lampropoulos
authors: A
authors: A
authors: Vezakis
authors: N
authors: N
authors: Paschalidis
authors: E
authors: E
authors: Balitsaris
authors: A
authors: A
authors: Zizi-Sermpetzoglou
authors: A
authors: A
authors: Hadjimarcou
authors: S
authors: S
authors: Rizos
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D010185:Pancreatic Fistula / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate