The effect of a pancreatic anastomosis leak on long-term survival after pancreaticoduodenectomy for ampullary cancers, distal cholangiocarcinomas and pancreatic ductal cancers

Abstract

Univariate and multivariate analysis of several preoperative and intraoperative variables were done to detect risk factors and predictor of morbidity and early mortality. Results: Between the first of January 2008 and the end of June 2013, 102 patients underwent pancreaticoduodenectomy at the National Liver Institute, Menoufiya University. As regard univariate analysis, the patient's age is the only preoperative variable found to be statistically significant with the incidence of delayed gastric emptying (P value > 0.05). As regard the univariate analysis of the intraoperative variables, the consistency of the pancreas, pancreatic duct size, operative time and blood loss were statistically significant with the incidence of pancreatic leak. The Blood loss was significant with the incidence of bile leak. The type of pancreaticoenteric anastomosis, pancreatic duct size and tumor size were significant with the incidence of delayed gastric emptying. The operative time, blood loss and blood transfusion were significant with the incidence of wound infection. As regard multivariate analysis, the origin of the tumor and blood loss was significant with the incidence of postoperative bile leak. The blood loss was significant with the postoperative wound infection. Conclusions: The patient's age, consistency of the pancreas, pancreatic duct size, operative time, blood loss Type of pancreaticoenteric anastomosis, and tumor size were risk factors with the incidence of major postoperative complications. In multivariate analysis, the origin of the tumor and intraoperative blood loss were significant with the incidence of postoperative bile leak and wound infection.

Long-term survival after minimally invasive resection versus open pancreaticoduodenectomy for periampullary cancers: a systematic review, meta-analysis and meta-regression

“…However, MIPD seems to be associated with a lower rate of severe complications compared with OPD, 6,58 which is likely due to less surgical trauma. 61 Major postoperative complications and reoperations after PD have been found to be associated with reduced long-term survival. [62][63][64] Pulmonary infections have been shown to be less common after MIPD, especially robotic surgery, 6 probably explained by the avoidance of a laparotomy.…”