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Original Papers

Pancreaticoduodenectomy for periampullary cancer: does the tumour entity influence perioperative morbidity and long-term outcome?

, , , , , & show all
Pages 341-347 | Received 14 Mar 2017, Accepted 22 Sep 2017, Published online: 11 Sep 2018
 

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

There was no funding from external sources in this study.

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.

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