Morbidity and mortality of the conventional cephalic duodenopancreatectomy in patients with biliopancreatic confluent disease

Abstract

Introduction: Cephalic duodenopancreatectomy is an increasingly frequent operation in selected patients. Objective: To identify the morbidity and mortality related to conventional cephalic duodenopancreatectomy. Methods: An observational, descriptive study of a series of 15 cases operated on cephalic duodenopancreatectomy. The variables were investigated: staging according to the Tumor, Linphonod, Metastasis (TNM) classification, pathological diagnosis, complications, surgical time and discharge status. Absolute number and percentage were used as summary measures for the variables staging and diagnosis; mean, median and range for surgical time and confidence interval for discharge status. Results: The main pathological diagnosis was adenocarcinoma of the pancreas with 9 patients (60,1 %) and of the duodenum with 2 (13,3 %). Postoperative stage IIA was the one that prevailed with 5 (45,5 %) patients. Delayed gastric emptying was the prevailing surgical complication, with 7 (46,7 %) patients, followed by biliary fistula with 3 (20,0 %). Pancreatic fistula, superior mesenteric vein injury, and postoperative hemorrhage occurred only once (6,7 %), respectively. These last 2, caused the death of the patient in the first 48 hours of the postoperative period. Four (26,7 %) patients in the series died. Conclusions: Postoperative complications are mainly observed at the expense of delayed gastric emptying and biliary and pancreatic fistula. Mortality may be related to the prolongation of surgical time equal to or greater than 5 hours with the consequent increase of blood loss.

Keywords

• confluente biliopancreático
• complicaciones
• duodenopancreatectomía cefálica
• estadificación, morbilidad
• mortalidad.