Duodenopancreatectomia: avaliação dos resultados em 41 pacientes

Rocha, Luiz Carlos Gomes; Queiroz, Fábio Lopes de; Magalhães, Eudes Arantes; Santos, Fernando Augusto de Vasconcellos; Caldeira, Daniel Adonai Machado; Ribas, M.

doi:10.1590/s0100-69912006000600011

Cited by 7 publications

(10 citation statements)

References 39 publications

(39 reference statements)

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“…In the other patients, clinical management was sufficient for good outcome. Other national series show similar results, reporting 9.7% pancreatic fistula rate (28) .…”

Section: Pancreatic Fistulasupporting

confidence: 69%

LOW MORTALITY RATE IN 97 CONSECUTIVE PANCREATICODUODENECTOMIES: the experience of a group

Fontes

Waechter

Nectoux

et al. 2014

Arq. Gastroenterol.

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-Context -Pancreaticoduodenectomy is the procedure of choice for resectable cancer of the periampullary region. These tumors account for 4% of deaths from cancer, being referred to as one of the lowest survival rates at 5 years. Surgery remains a complex procedure with substantial morbidity and mortality. Despite reports of up to 30% mortality rates, in centers of excellence it have been identified as less than 5%. Recent studies show that pancreaticojejunostomy represents the "Achilles' heel" of the procedure.Objective -To evaluate the post-operative 30 days morbidity and mortality rates. Methods -Retrospective analysis of 97 consecutive resected patients between July, 2000 and December, 2012. All patients were managed by the same group, and data were obtained from specific database service. The main objective was to evaluate the 30-day mortality rate, but we also studied data of surgical specimen, need for vascular resection and postoperative complications (gastric stasis, pancreatic fistula, pneumonia and reoperation rate).Results -Thirty-day mortality rate was 2.1% (two patients). Complete resection with no microscopic residual tumor was obtained in 93.8% of patients, and in 67.3% of cases pathology did not detected metastatic nodes. Among postoperative complications were reported 6% of prolonged gastric stasis, 10.3% of pneumonia, 10.3% of pancreatic fistula and 1% of infection in the drain pathway. Two patients underwent reoperation due to bleeding and infected hematoma caused by pancreatic fistula, and another for intestinal obstruction because of adhesions at postoperative day 12. Conclusion -The pancreaticoduodenectomy as treatment procedure for periampullary cancers has a low morbidity and mortality rate in services with experience in Hepato-Pancreato-Biliary surgery, remaining as first-line treatment in resectable patients. HEADINGS -Pancreatic neoplasms. Pancreaticoduodenectomy. Mortality.

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“…In the other patients, clinical management was sufficient for good outcome. Other national series show similar results, reporting 9.7% pancreatic fistula rate (28) .…”

Section: Pancreatic Fistulasupporting

confidence: 69%

LOW MORTALITY RATE IN 97 CONSECUTIVE PANCREATICODUODENECTOMIES: the experience of a group

Fontes

Waechter

Nectoux

et al. 2014

Arq. Gastroenterol.

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“…In general, mortality rates found in national publications by the year 2012 ranged between 4.3% and 21.9% [8][9][10][11][12][13][14] , being superior to those described in the international literature 3 .…”

Section: Results Results Results Resultsmentioning

confidence: 74%

Fifty consecutive pancreatectomies without mortality

Amico

Barreto

Alves

et al. 2016

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTObjective: Objective: Objective: Objective: Objective: to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. Methods:Methods: Methods: Methods: Methods: we prospectively studied 50 consecutive patients undergoing pancreatic resections for periampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. Results:Results: Results: Results: Results: patients' age ranged between 16 and 90 years (average: 53.3). We found anemia (Hb < 12g/dl) and preoperative jaundice in 38% and 40% of cases, respectively. Most patients presented with peri-ampullary tumors (66%). The most common surgical procedure was the Kausch-----Whipple operation (70%). Six patients (12%) needed to undergo resection of a segment of the mesenteric-portal axis. The mean operative time was 445.1 minutes. Twenty two patients (44%) showed no clinical complications and presented mean hospital stay of 10.3 days. The most frequent complications were pancreatic fistula (56%), delayed gastric emptying (17.1%) and bleeding (16%). Conclusion Conclusion Conclusion Conclusion Conclusion: within the last three decades, pancreatic resection is still considered a challenge, especially outside large specialized centers. Nevertheless, even in our country (Brazil), teams seasoned in such procedure can reach low mortality rates.

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“…In a recent retrospective study conducted at our institution with patients undergoing PD (with or without vascular resection) between 2012 and 2017, the overall mortality observed was 10.3% (13) . Analyzing the standard surgery without vascular resection, Rocha et al (25) , in a sample of 41 patients, observed morbidity of 58% and surgical mortality of 22%. Wanderlay et al (26) , analyzing 21 patients, verified a morbidity of 21.7% and mortality of 17.3%.…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy With Venous Resection: An Analysis of 30-Day Morbidity and Mortality

Callejas

Concon

Rezende

et al. 2019

Arq. Gastroenterol.

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BACKGROUND: Pancreaticoduodenectomy (PD) with the resection of venous structures adjacent to the pancreatic head, even in cases of extensive invasion, has been practiced in recent years, but its perioperative morbidity and mortality are not completely determined. OBJECTIVE: To describe the perioperative outcomes of PD with venous resections performed at a tertiary university hospital. METHODS: A retrospective study was conducted, classified as a historical cohort, enrolling 39 individuals which underwent PD with venous resection from 2000 through 2016. Preoperative demographic, clinical and anthropometric variables were assessed and the main outcomes studied were 30-day morbidity and mortality. RESULTS: The median age was 62.5 years (IQ 54-68); 55% were male. The main etiology identified was ductal adenocarcinoma of the pancreas (82.1%). In 51.3% of cases, the portal vein was resected; in 35.9%, the superior mesenteric vein was resected and in the other 12.8%, the splenomesenteric junction. Regarding the complications, 48.7% of the patients presented some type of morbidity in 30 days. None of the variables analyzed was associated with higher morbidity. Perioperative mortality was 15.4% (six patients). The group of individuals who died within 30 days presented significantly higher values for both ASA (P=0.003) and ECOG (P=0.001) scores. CONCLUSION: PD with venous resection for advanced pancreatic neoplasms is a feasible procedure, but associated with high rates of morbidity and mortality; higher ASA e ECOG scores were significantly associated with a higher 30-day mortality.

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Duodenopancreatectomia: avaliação dos resultados em 41 pacientes

Cited by 7 publications

References 39 publications

LOW MORTALITY RATE IN 97 CONSECUTIVE PANCREATICODUODENECTOMIES: the experience of a group

LOW MORTALITY RATE IN 97 CONSECUTIVE PANCREATICODUODENECTOMIES: the experience of a group

Fifty consecutive pancreatectomies without mortality

Pancreaticoduodenectomy With Venous Resection: An Analysis of 30-Day Morbidity and Mortality

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