Early reoperation following pancreaticoduodenectomy: impact on morbidity, mortality, and long-term survival.
Aged
Anastomotic Leak
/ surgery
Bile Duct Neoplasms
/ surgery
Carcinoma, Pancreatic Ductal
/ surgery
Cholangiocarcinoma
/ surgery
Female
Humans
Male
Middle Aged
Morbidity
Pancreatic Neoplasms
/ surgery
Pancreaticoduodenectomy
/ adverse effects
Postoperative Complications
/ surgery
Reoperation
/ statistics & numerical data
Retrospective Studies
Complication
Pancreas
Surgery
Whipple
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
31 Jan 2019
31 Jan 2019
Historique:
received:
22
11
2018
accepted:
23
01
2019
entrez:
2
2
2019
pubmed:
2
2
2019
medline:
9
2
2019
Statut:
epublish
Résumé
Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effect on short- and long-term outcome. Four hundred and thirty-three patients that underwent PD between August 2006 and June 2016 were retrospectively analyzed. Forty-eight patients (11%; ROp group) underwent 60 reoperations within 60 days from PD. Forty-two patients underwent 1 reoperation, and 6 had up to 6 reoperations. The average time to first reoperation was 10.1 ± 13.4 days. The most common indications were anastomotic leaks (22 operations in 18 patients; 37.5% of ROp), followed by post-pancreatectomy hemorrhage (PPH) (14 reoperations in 12 patients; 25%), and wound complications in 10 (20.8%). Patients with cholangiocarcinoma had the highest reoperation rate (25%) followed by ductal adenocarcinoma (12.3%). Reoperation was associated with increased length of hospital stay and a high post-operative mortality of 18.7%, compared to 2.6% for the non-reoperated group. For those who survived the post-operative period, the overall and disease-free survival were not affected by reoperation. Early reoperations following PD carries a dramatically increased mortality rate, but has no impact on long-term survival.
Sections du résumé
BACKGROUND
BACKGROUND
Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effect on short- and long-term outcome.
METHODS
METHODS
Four hundred and thirty-three patients that underwent PD between August 2006 and June 2016 were retrospectively analyzed.
RESULTS
RESULTS
Forty-eight patients (11%; ROp group) underwent 60 reoperations within 60 days from PD. Forty-two patients underwent 1 reoperation, and 6 had up to 6 reoperations. The average time to first reoperation was 10.1 ± 13.4 days. The most common indications were anastomotic leaks (22 operations in 18 patients; 37.5% of ROp), followed by post-pancreatectomy hemorrhage (PPH) (14 reoperations in 12 patients; 25%), and wound complications in 10 (20.8%). Patients with cholangiocarcinoma had the highest reoperation rate (25%) followed by ductal adenocarcinoma (12.3%). Reoperation was associated with increased length of hospital stay and a high post-operative mortality of 18.7%, compared to 2.6% for the non-reoperated group. For those who survived the post-operative period, the overall and disease-free survival were not affected by reoperation.
CONCLUSIONS
CONCLUSIONS
Early reoperations following PD carries a dramatically increased mortality rate, but has no impact on long-term survival.
Identifiants
pubmed: 30704497
doi: 10.1186/s12957-019-1569-9
pii: 10.1186/s12957-019-1569-9
pmc: PMC6357503
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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