Our Experience with Pancreatic Resection Procedures. Retrospective Analysis
Authors:
B. Jon 1; F. Čečka 1; A. Ferko 1,2; Z. Šubrt 1,2
Authors place of work:
Chirurgická klinika Fakultní nemocnice Hradec Králové a Lékařské fakulty UK v Hradci Králové
přednosta kliniky: doc. MUDr. A. Ferko, CSc.
1; Katedra válečné chirurgie, Fakulta vojenského zdravotnictví, Univerzita Obrany Brno, vedoucí katedry: doc. MUDr. A. Ferko, CSc.
2
Published in the journal:
Rozhl. Chir., 2008, roč. 87, č. 4, s. 195-199.
Category:
Monothematic special - Original
Summary
Introduction:
Pancreatic resections are highly demanding surgical procedures, which require higher specialization of the surgical teams and concentration of the patients into the specialized centers. The aim of our study was to analyze our results of the surgical therapy at a center which performs approximately 15 resections and 20 other procedures on pancreas a year.
Methods:
A group of patients with pancreatic resection operated on at the Department of Surgery, University Hospital in Hradec Králové between 1996 and 2006 was analyzed retrospectively. Postoperative mortality and postoperative complications were recorded. Long-term survival was evaluated only in patients with carcinoma.
Results:
158 pancreatic resections were performed in the referred period, 116 partial duodenopancreatectomies, 1 total duodenopancreatectomy and 41 distal resections of pancreas. 30-day postoperative mortality after duodenopancreatectomy was 4.3%. There was no postoperative death after the distal resection. Severe complications were recorded in 22 patients (13.9 %). Median survival of the patients was 11 months. 15 out of 68 patients (22.1%) survived 5 years, 30 out of 89 patients (33.7%) survived 3 years.
Conclusion:
Our results of surgical therapy are comparable with the results of other hospitals with similar frequency of the pancreas resection, regarding postoperative mortality and morbidity, also regarding long-term results.
Key words:
pancreatic cancer – pancreas resection – duodenopancreatectomy – postoperative complications
Zdroje
1. Crist, D. W., Sitzmann, J. V., Cameron, J. L. Improved hospital morbidity, mortality, and survival after the Whipple proceduře. Ann. Surg., 1987, roč. 206, s. 358-365.
2. Dindo, D., Demartines, N., Clavien, P-A. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann. Surg., 2004, roč. 240, s. 205–213.
3. Ústav zdravotnických informací a statistiky ČR, publikace Novotvary 2004 ČR, dostupné také na http://www.uzis.cz/news.php?article=624&order=&sort=&rnnu_id=l 100.
4. Šálek, C. Nové poznatky k epidemiologii nádorů pankreatu. Bulletin HPB, 2004, roč. 12, s. 86–90.
5. Kausch, W. Das Carcinom der Papilla duodeni und seine radikale Entfernung. Beitr. klin. Chir., 1912, roč. 78, s. 439–486.
6. Whipple, A. O., Parsons, W. B., Mullins, C. R. Treatment of carcinoma of the ampulla of Vater. Ann. Surg., 1935, roč. 102, s. 763–779.
7. Cameron, J. L., Riall, T. S., Coleman, J., Belcher, K. A. One thousand consecutive pancreaticoduodenectomies. Ann. Surg., 2006, roč. 244, s. 10–15.
8. Trede, M., Schwall, G., Saeger, H-D. Survival after pancreaticoduodenectomy: 118 consecutive resections without an operative mortality. Ann. Surg., 1990, roč. 211, s. 447–458.
9. Cameron, J. L., Pitt, H. A., Yeo, C. J., et al. One-hundred and forty-five consecutive pancreaticoduodenectomies without mortality. Ann. Surg., 1993, roč. 217, s. 430–438.
10. Yeo, C. J., Cameron, J. L., Sohn, T. A., et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann. Surg., 1997, roč. 226, s. 248–260.
11. Pešková, M., Gürlich, R. Předoperační biliární drenáž u karcinomu hlavy pankreatu. Rozhl. Chir., 2004, roč. 83, s. 624–628.
12. Leffler, J., Polouček, P., Krejčí, T. Karcinom hlavy pankreatu a periampulární karcinomy. Výsledky resekční léčby za 10 let. Rozhl. Chir., 2005, roč. 84, s. 610–616.
13. Krejčí, T., Leffler, J., Polouček, P. Dlouhodobé výsledky po radikálních resekcích pro duktální adenokarcinom pankreatu – desetileté zkušenosti. Rozhl. Chir., 2007, roč. 86, s. 174–179.
14. Ryska, M., Strnad, R., Bělina, F., et al. Radikální resekce u nemocných s karcinomem hlavy pankreatu. Retrospektivní analýza přežívání u souboru 307 nemocných. Rozhl. Chir., 2007, roč. 86, s. 432–439.
15. Bassi, C, Falconi, M., Salvia, R., et al. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig. Surg., 2001, roč. 18, s. 453–458.
16. Seiler, C. A., Wagner, M., Bachmann, T., et al. Randomized clinical trial of pylorus preserving duodenopancreatectomy versus classical Whipple resection – long term results. Br. J. Surg., 2005, roč. 92, s. 547–556.
17. Büchler, M. W., Wagner, M., Schmied, B. M, et al. Changes in morbidity after pancreatic resection. Toward the end of completion pancreatectomy. Arch. Surg., 2003, roč. 138, s. 1310–1314.
18. Böttger, T. C, Junginger, T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections. World J. Surg., 1999, roč. 23, s. 164–172.
19. Birkmeyer, J. D., Siewers, A. E., Finlayson, E. V. A., et al. Hospital volume and surgical mortality in the United States. N. Engl. J. Med., 2002, roč. 346, s. 1128–1137.
20. Birkmeyer, J. D., Stukel, T. A., Siewers, A. E., et al. Surgeon volume and operative mortality in the United States. N. Engl. J. Med., 2003, roč. 349. s. 2117–2127.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2008 Číslo 4
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Patient Quality of Life Following Resection Procedures for Chronic Pancreatitis
- Experience With Ventral Hernioplasties According to Chevrel With „On-lay“ Prolene Mesh
- Chronic pancreatitis, Indications for Resection Procedures and Postoperative Complications
- Our Experience with Pancreatic Resection Procedures. Retrospective Analysis