Long-term anastomotic complications after pancreaticoduodenectomy for benign diseases

The study of long-term complications after pancreaticoduodenectomy (PD) for malignant disease has been problematic given the paucity of patients with long-term survival after diagnosis and surgical resection. We therefore studied patients who were surgically treated with a PD for a benign diagnosis...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2007-12, Vol.11 (12), p.1704-1711
Main Authors: Reid-Lombardo, Kaye M, Ramos-De la Medina, Antonio, Thomsen, Kristine, Harmsen, William S, Farnell, Michael B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical
Bile Ducts, Extrahepatic - pathology
Constriction, Pathologic
Cystadenoma, Mucinous - surgery
Female
Humans
Male
Middle Aged
Mortality
Pancreas
Pancreatic Diseases - diagnosis
Pancreatic Diseases - surgery
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy - adverse effects
Pancreaticoduodenectomy - methods
Pancreatitis, Chronic - diagnosis
Pancreatitis, Chronic - mortality
Pancreatitis, Chronic - surgery
Proportional Hazards Models
Surgery
Survival Analysis
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Summary:The study of long-term complications after pancreaticoduodenectomy (PD) for malignant disease has been problematic given the paucity of patients with long-term survival after diagnosis and surgical resection. We therefore studied patients who were surgically treated with a PD for a benign diagnosis to evaluate long-term anastomotic durability. A retrospective analysis of 122 patients who had PD performed in the interval 1993-2003 inclusive for benign pancreatic diseases was undertaken. Long-term morbidity and mortality (specifically biliary, pancreaticojejunostomy [PJ], and gastrojejunostomy [GJ] strictures) were evaluated. Gender was equally represented with 53% female and 47% male. The median age at surgery was 55 years (range 15-81 years). The three most frequent diagnoses were chronic pancreatitis (40%), intraductal papillary mucinous neoplasm (16%), and cystic neoplasms (9%). Median follow-up in the 95 patients alive at last follow-up was 4.1 years (10 days-12.6 years). The 5- and 10-year survival rates were 83% (76, 91%) and 62% (49%, 78%), respectively. The observed survival was significantly lower than the expected survival in an age- and gender-matched U.S. white population, p
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-007-0369-7