Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma Journal Article

   

Authors:	Pugalenthi, A.; Protic, M.; Gonen, M.; Kingham, T. P.; D'Angelica, M. I.; DeMatteo, R. P.; Fong, Y.; Jarnagin, W. R.; Allen, P. J.
Article Title:	Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma
Abstract:	Introduction Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40-50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. Methods A total of 596 patients that underwent PD for PDA between 2001 and 2009 were identified from a prospective database. Complications were defined and graded (1-5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥grade 3. Postoperative mortality (≤90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. Results Median survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n = 129). Our 90 day mortality was 3.7% (n = 22). Anastomotic fistula/leak/abscess rate was 14% (n = 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) >600 ml, length of stay (LOS) >10 days, margin positivity, and vascular procedures as predictors of decreased overall survival (P < 0.05). High grade complications were not associated with overall survival (P = 0.948). Conclusion In this study, the occurrence of high grade postoperative complications was not associated with overall survival. © 2015 Wiley Periodicals, Inc.
Keywords:	survival; pancreaticoduodenectomy; complications; pancreatic ductal adenocarcinoma
Journal Title:	Journal of Surgical Oncology
Volume:	113
Issue:	2
ISSN:	0022-4790
Publisher:	Wiley Blackwell
Date Published:	2016-02-01
Start Page:	188
End Page:	193
Language:	English
DOI:	10.1002/jso.24125
PROVIDER:	scopus
PUBMED:	26678349
PMCID:	PMC4830358
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84957850494&partnerID=40&md5=439ad218bf1ee13c5dab307ebc729258
Notes:	Article -- Export Date: 3 March 2016 -- Source: Scopus

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