Zubair Abdullah Bin, Khan Sherwani Ismail Abdur Rahman, Ahmad Muhammad, Tahir Mohammed Ahmad, Khalil Muhammad Ibrahim, Bukhari Mohammad Mudassar, Sabir Muzammil, Bhatti Assadullah A, Afzal Nitasha, Kaneez Mehwish
Surgery, Rashid Latif Medical College, Lahore, PAK.
Surgery, Bahawal Victoria Hospital, Bahawalpur, PAK.
Cureus. 2022 Feb 14;14(2):e22218. doi: 10.7759/cureus.22218. eCollection 2022 Feb.
Background Pancreaticoduodenectomy is an extremely complex surgical procedure that mandates aggressive postoperative management. Unfortunately, in developing countries, the limited resources and poor postoperative care lead to multiple complications and abysmal outcomes. Therefore, our study aimed to evaluate the spectrum of postoperative complications and outcomes among patients undergoing pancreaticoduodenectomy. Methods This retrospective study involved a total of 97 patients who underwent pancreaticoduodenectomy for ampullary, periampullary, or pancreatic tumors. Patients with advanced metastasis and unresectable tumors were excluded from the study. Patients were studied for various parameters including the demographic details, postoperative outcomes, characteristics of the tumor, and postoperative complications. Results Out of 97 patients, 59 (60.8%) patients were males. The mean age of the study participants was 53.43 ± 17.89 years. Jaundice and abdominal pain were the most common presenting symptoms among the study participants. Of the 97 patients, 58 (59.8%) had malignant tumors. A total of 49 patients developed various postoperative complications including surgical site infections (10.3%), anastomosis leakage (9.27%), pancreatic fistula (9.27%), cholangitis (7.2%), and biliary leakage (4.1%). A total of 29 (29.9%) patients expired due to postoperative complications. Conclusions Surgical site infections, anastomosis leakage, pancreatic fistula, cholangitis, and biliary leakage are common but preventable postoperative complications after pancreaticoduodenectomy. These lead to morbidity and mortality, especially in the setting of a resource-deprived developing country. Aggressive postoperative management, improved surgical technique, better intraoperative hemostasis management, and a multi-disciplinary approach for the management of such patients can help in preventing postoperative complications and improving the postoperative outcomes.
胰十二指肠切除术是一种极其复杂的外科手术，需要积极的术后管理。不幸的是，在发展中国家，资源有限且术后护理不佳导致多种并发症和糟糕的预后。因此，我们的研究旨在评估接受胰十二指肠切除术患者的术后并发症谱及预后。
这项回顾性研究共纳入97例因壶腹、壶腹周围或胰腺肿瘤接受胰十二指肠切除术的患者。有远处转移和不可切除肿瘤的患者被排除在研究之外。对患者的各种参数进行研究，包括人口统计学细节、术后结局、肿瘤特征和术后并发症。
97例患者中，59例（60.8%）为男性。研究参与者的平均年龄为53.43±17.89岁。黄疸和腹痛是研究参与者中最常见的首发症状。97例患者中，58例（59.8%）患有恶性肿瘤。共有49例患者发生了各种术后并发症，包括手术部位感染（10.3%）、吻合口漏（9.27%）、胰瘘（9.27%）、胆管炎（7.2%）和胆漏（4.1%）。共有29例（29.9%）患者因术后并发症死亡。
手术部位感染、吻合口漏、胰瘘、胆管炎和胆漏是胰十二指肠切除术后常见但可预防的术后并发症。这些并发症会导致发病和死亡，尤其是在资源匮乏的发展中国家。积极的术后管理、改进手术技术、更好的术中止血管理以及对这类患者采用多学科方法有助于预防术后并发症并改善术后结局。
