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Abstract
Background: Malignant tumours of the periampullary region include ductal adenocarcinoma of the pancreas (Pan-Ca), distal bile duct cancer (DBDC) and adenocarcinoma of the ampulla (Amp-Ca). The present retrospective clinical study was designed to evaluate the influence of tumour entity on postoperative complications and identify risk factors predicting survival and morbidity.
Methods: We retrospectively analysed data from all patients who underwent pancreatic resection for periampullary cancer with curative intent (R0 or R1). Demographic data, risk factors, perioperative complications and survival rates for the different subtypes were assessed.
Results: A total of 225 patients with periampullary cancer were identified: 124 (55.1%) had Pan-Ca, 55 (24.4%) had DBDC and 46 had (20.4%) Amp-Ca. Sixty-nine patients (30.7%) had major complications (grade IIIb–V). Patients with DBDC had significantly more grade C pancreatic fistulas. Univariate analysis revealed male gender, BMI >30, R1-status, and low-grade tumour differentiation as risk factors for major complications. Overall in-hospital-mortality was 6.7%.
Conclusions: Further research will be needed to implement more individualized therapy.
Disclosure statement
The authors report no conflict of interest. None of the authors has any financial interest or benefit that has arisen from the direct applications of our research.
Additional information
Funding
Notes on contributors
Georg Wiltberger
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Felix Krenzien
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Georgi Atanasov
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Hans-Michael Hau
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Moritz Schmelzle
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Michael Bartels
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.
Christian Benzing
GW, FK, and MB were responsible for the study conception and design; GW, CB, JB, FK, GA, and H-MH were responsible for data acquisition; GW, FK, H-MH, and MB analysed and interpreted the data; GW and CB drafted the manuscript; and FK, CB, and MB critically revised the manuscript.