Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Parasyris Stavros
Dissertation committee:
Παντελεήμων Βασιλείου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βασίλειος Σμυρνιώτης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σπυρίδων Χριστοδούλου, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Αρκαδόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Δανιάς, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παύλος Πατάπης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τατιανή Σιδηροπούλου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Περιεγχειρητικοί παράγοντες που καθορίζουν την πρόγνωση μετά από παγκρεατεκτομή για νεοπλάσματα του παγκρέατος
Translated title:
Perioperative factors that determine prognosis post pancreatectomy for periampullary neoplasms
Summary:
Introduction:
Despite technical advances in recent decades and a decrease in hospital mortality
(<5%), Pancreaticoduodenectomy (PD) is still associated with major postoperative
complications even in high volume centers. This study was designed to assess the
effect of a modified reconstruction technique and other perioperative factors on postoperative
morbidity and mortality.
Methods:
A cohort study of all patients (n=218) undergoing PD between January 2010 and
December 2019 was performed at Attikon University Hospital. Several variables were
studied, such as patient demographic data, medical history, tumor markers and pathology,
perioperative parameters, hospitalization days, post-operative complications,
thirty-day-survival, post-operative mortality and overall survival.
Results:
In this cohort, 123 patients (group A) underwent a modified reconstruction after a
pylorus-preserving PD which consisted of gastro- and pancreatic-jejunostomy on the
same loop and an isolated hepaticojejunostomy on another loop. In group B, 95 patients
underwent the standard reconstruction. Median age was 67 years, ranging from
25 to 89. Group A compared to group B had significantly lower rates of pancreatic
fistula (4.9% vs 28.4%), delayed gastric emptying (7.3% vs 42.1%), post-operative
hemorrhage (3.3% vs 20%), intensive care unit admission (8.1% vs 18.9%), overall
morbidity (Clavien-Dindo>2: 14.7% vs 42%), peri-operative mortality (4.1% vs 14.7%)
and shorter hospitalization stay (11 days vs 20 days). However, no difference was noted
regarding median survival (35 months vs 30 months).
Conclusion:
In the present single center series, a modified reconstruction after PD appears to be
associated with improved postoperative outcomes and thus deserves further evaluation
in larger multi-center trials.
Main subject category:
Health Sciences
Keywords:
Pancreaticoduodenectomy, Post-operative morbidity, Mortality, POPF, DGE
Number of references:
168
