Pancreaticoduodenectomy in a tertiary referral center in Saudi Arabia : a retrospective case series

Abstract EN

Context: Perioperative outcome of pancreatic duodenectomy is related to work load volume and to whether the procedure is carried out in a tertiary specialized hepatic-pancreatic-biliary HPB) unit.) Objective : to evaluate the perioperative outcome associated with pancreatic duodenectomy in a newly established HPB unit Patients : analysis of 32 patients who underwent pancreatic duodenectomy (PD) for benign and malignant indications.

Design : retrospective collection of data on preoperative, intraoperative and postoperative care of all patients undergoing PD Results : Thirty-two patients (16 male and 16 female) with a mean age of 59.5 ± 12.7 years were analyzed.

The overall morbidity rate was high at 53 %.

The most common complication was wound infection (n = 11 ; 34.4 %).

Pancreatic and biliary leaks were seen in 5 (15.6 %) and 2 (6.2 %) cases, respectively, while delayed gastric emptying was recorded in 7 (21.9 %).

The female sex was not associated with increased morbidity.

Presence of co-morbid illness, pylorus-preserving PD, intra-operative blood loss P1 L, and perioperative blood transfusion were not associated with significantly increased morbidity.

The overall hospital mortality was 3.1 % and the cumulative overall (OS) and disease free survival (DFS) at 1 year were 80 % and 82.3 %, respectively.

The cumulative overall survival for pancreatic cancer vs ampulla tumor at 1 year were 52 % vs 80 %, respectively.

Conclusion: PD is associated with a low risk of operative death when performed by specialized HPB surgeons even in a tertiary referral hospital.

However, the postoperative morbidity rate remains high, mostly due to wound infection.

Further improvement by reducing postoperative infection may help curtail the high postoperative morbidity.