Prognostic factors for survival and surgical complications in Whipple's pancreatoduodenectomy during a 10-year experience.

BACKGROUND

Periampullary neoplasms account for over 30,000 cancer-related deaths per year in the United States. Pancreaticoduodenectomy (PD) is considered the surgical standard and is the only curative treatment option for these pathologies.

OBJECTIVE

The objective of this study was to report the prognostic factors in survival and surgical complications in PD.

MATERIALS AND METHODS

A total of 178 cases are reported, several variables were reviewed and the same surgical technique was used by the same surgeon.

RESULTS

A total of 151 PD were reviewed. The most common initial symptoms were jaundice, 111 (73%), abdominal pain, 20 (13%), and oral intolerance, 10 (6%). Poor prognostic factors for survival were the presence of a previous pathology, days of hospitalization, positive margins, and weight loss.

DISCUSSION

With the experience gained, a decrease in surgical time, intraoperative bleeding, and transfusions performed was achieved. Our complication rate remained at 20%, lower than that reported in literature.

CONCLUSION

PD is the only option of cure for patients with pancreatic and periampullary tumors. This procedure has been linked to high morbidity and mortality even in high-volume centers. A pancreatic fistula is the most feared complication; therefore, multiple pancreatojejunostomy techniques have been described in literature. It is important to continue reporting these cases to reach a consensus on this technique.