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Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases

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World Journal of Gastroenterology 2017年第38期23卷 7025-7036页

作者： ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta m.ham.d el sorogy emad hamdy m.ham.d el hemly ahmed a el-geidi tharwat kandil m.ham.d el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan m.ham.d abdel wahab gastroenterology surgical center mansoura university

AIm To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(Pds) for periampullary *** This is a retrospective review of the data of all patients who underwent Pd for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed Pd was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for Pd. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the *** Surgical results of Pd significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following Pd is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.

关键词： Pancreaticoduodenectomy Pancreaticogastrostomy Pancreaticojejunostomy Postoperative pancreatic fistula Periampullary tumor

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