Pancreaticoduodenectomy experience in a low-volume center for pancreatic resection
H. Hakan Mersin1, Emin Yıldırım2, Fikret İrkin1, Uğur Berberoğlu1, Kaptan Gülben1
1Ankara Onkoloji Hastanesi, 2. Genel Cerrahi, Ankara, Türkiye
2Bozok Üniversitesi Tıp Fakültesi, Genel Cerrahi, Yozgat, Türkiye
Abstract
Purpose: The aim of this study was to evaluate the experience in pancreaticoduodenectomy in a low volume hospital for pancreatic resection.
Patients and Methods: The hospital charts of the patients with periampullary and pancreatic head and neck cancer that underwent pancreaticoduodenectomy (group 1) or palliative surgical treatment (group 2) from January 1999 to December 2002 were retrospectively reviewed. Morbidity and mortality rates of the surgical procedures, and the patients' outcomes were evaluated. Kaplan-Meier method was used for survival analyses.
Results: There were 22 patients in group 1 and 13 patients in group 2. The operative mortality and morbidity rates for group 1 were 13.6% and 34.6%, respectively. There was no operative mortality and/or morbidity in group 2. The median overall survival (OS) rate 41 months (%95 CI: 28-56) for group 1 and 6 months (%95 CI: 5-7) for group 2 (p<0.0001). Whereas 5-year overall survival was 76% (±0.09) in the first group, 6-months overall survival was 31% (±0.1) in the second group (p<0.0001).
Conclusion: Although, pancreaticoduodenectomy has a higher mortality in low-volume hospitals for pancreatic resection, as in this study, it still remains the most effective treatment in periampullary and pancreatic head and neck cancers and improves the clinical outcome.
Keywords: Periampullary cancer, pancreatic cancer, pancreaticoduodenectomy, mortality, survival