Impact of Postoperative Complications on Survival of Patients with Pancreatic Carcinoma

Česká verzia

Authors: J. Kaťuchová; J. Bober; J. Radoňak
Authors place of work: I. chirurgická klinika LF UPJŠ a UNLP Košice, Slovenská republika, prednosta: prof. MUDr. J. Radoňak, CSc
Published in the journal: Rozhl. Chir., 2011, roč. 90, č. 3, s. 174-181.
Category: Monothematic special - Original

Summary

Introduction:
In spite of radical pancreatic resection and adjuvant therapy, the overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months.

Material and Methods:
Between January 2000 and December 2009, the prospective study was performed to indentify the presence of postoperative complications and to find their influence on survival rate in pancreatic cancer patients.

Results:
Between January 2000 and December 2009, the radical pancreatic resection was performed for 102 patients suffer from pancreatic cancer, at the I. Department of Surgery University Hospital in Košice.

Pancreatoduodenectomies were performed in Child-Stulhofer modification in 59 patients, Whipple modification was performed in 31 patients, Waugh-Clagett in 2 patients, Traverso-Longmire in 2 patients, distal resection of pancreas was performed in 7 patients and one patient had made total pancreatectomy.

The overall morbidity rate was 30.2% (31 patients) and mortality rate was 3.9% (4 patients). Specific (for pancreatic resection) complications were indentified in 26 patients, 25.3%. Non-specific complications were presented in 5 patients, 4.9%.

Two intraoperative risk factors were found to be significantly associated with pancreatic leakage, small pancreatic duct size and soft texture of the remnant pancreas.

The 5-years survival rate for patients with pancreatic cancer was in 5 patients, 4.9 %, with median survival rate 15 months. In group of patients with postoperative complications median survival rate was 13 months, in group of patients without postoperative complications median survival time was 18 months.

Conclusion:
Long-term survival rate for pancreatic cancer patients is still low. The presence of postoperative complications had negative influence to survival rate in pancreatic cancer patients. Pancreatic leakage is the most afraid complications. Patients with a small pancreatic duct size or a soft pancreatic remnant were at high risk of pancreatic leakage.

Key words:
pancreatic cancer – postoperative complications – pancreatic leakage – survival rate

Zdroje

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