Have a personal or library account? Click to login
Impact factors for perioperative morbidity and mortality and repercussion of perioperative morbidity and long-term survival in pancreatic head resection Cover

Impact factors for perioperative morbidity and mortality and repercussion of perioperative morbidity and long-term survival in pancreatic head resection

Open Access
|Sep 2017

Figures & Tables

Surgical complications in 240 operated patients

Type of all surgical complications (n = 240)n%% 90-day mortality
No surgical complications16970.43
PF B or C2811.725
PF B or C and bleeding83.362.5
Bleeding in the intestines20.80
Intraabdominal bleeding – no PF41.725
Bile leak104.20
Leak from GEA52.120
Dehiscence of laparotomy31.30
Intraabdominal abscess62.50
Ileus10.40
Thrombosis of vascular graft20.80
Volvulus coeci10.40
Stenosis of coeliac trunk10.40
Total240100.07.9%

Observed clinicopathological features in 240 operated patients

P1 (n/%)P2 (n/%)All (n/%)p
male5180131
53.1%55.6%54.6%
Gender (n = 240)0.4
female4564109
46.9%44.4%45.4%
Age (n = 240)Mean (years)66.1 ± 9.965.98 ± 10.166.40.91
1174317
17.7%29.9%17.7%
ASA (n = 240)25368530.103
55.2%47.2%55.2%
3263326
27.1%22.9%27.1%
Preoperative histology (n = 240)432360.0001
4.2%22.2%15.0%
Hospital stay (n = 222)Mean (days)21.2 ± 14.519 ± 11.619.80.138
Preoperative total bilirubin (n = 240)Mean (mmol/l)(mmol/l)67.6 ± 71.579.0 ± 85.574.70.028
Preoperative endoscopic biliary drainage (EBD) (n = 240)3451850.554
35.4%35.4%35.4%
P1(n/%)P2(n/%)All(n/%)p
PD92115207
Type of pancreatic resection (n = 240)95.8%79.9%86.3%0.0001
TP42933
4.2%20.8%14.2%
Resection of VMS/VP (n=240)1228400.17
12.5%19.4%16.7%
Direct suture101424
Type of vascular reconstruction (n=240)10.4%9.7%10.0%0.043
Vascular graft21416
2.1%9.7%6.7%
Overall complications (OAC) (n=240)3455890.383
35.4%38.2%37.1%
30-day mortality (n=240)75120.152
7.3%3.5%5.0%
90-day mortality (n=240)118190.080
11.5%5.6%7.9%

Correlation of clinicopathological factors and perioperative morbidity and mortality in 240 operated patients

NOACPASCPBCPOLPAAPPLPAGCP
Age (years)240No compl.64.6 ± 100.00565.3 ± 10.30.05166.2 ± 100.45266 ± 100.665650 05665.7 ± 100.25665.4 ± 100.007
Compl.68.4 ± 9.167.9 ± 9.163.5 ± 1267.1 ± 87367.3 ± 870.1 ± 9
Age240<7028.6%0.01123.8%0.0718.6%0.0944.8%0.3690%0.03016.3%0.2348.6%0.021
(<70 and >69)>6943.7F%33.3%3.7%6.7%100%21.4%18.5%
ASA 1.2 vs. 3240ASA 1+232%0.00423.8%0.0425.5%0.4655.5%0.4650.45716.1%0.04210.5%0.006
ASA 352.5%33.3%6.8%6.8%29.5%25.4%
Total bilirubin240No compl.70.1 ± 740.27168.3 ± 73.60.06271 ± 770.00574.4± 780.9690.23168.1 ± 700.19579 ± 820.033
(mmol/l)Compl.82.9 ± 8989.5 ± 93.1134 ± 10475.5 ± 10891.4 ± 9947.4 ± 61
EBD240No EBD33.5%0.08224.5%0.0245.8%0.5947.1%0.2030.64012.8%0.00411.6%0.092
(no/yes)EBD43.5%37.6%5.9%3.5%30%18.8%
PD/TP240PD37.2%0.54529.5%0.4886.3%0.4005.8%0.6001%0.004--13%0.126
TP36.4%27.3%3%6.1%12.1%21.2%
Vasc. resect.240No vasc.39.5%0.11530.0%0.3344.5%0.0636%0.5780.73821.1%0.08316.5%0.011
(yes/no)Vasc. resect.27.5%25.0%12.5%5%7.7%2.5%
Size of tumor201No compl.32.3 ± 190.00131.7 ± 18.80.00229.5 ± 170.18729.4 ± 170.3200.06930.3 ± 180.00129.7 ± 170.211
(mm)Compl.24.6 ± 1223.7 ± 10.125 ± 1025.1 ± 1322.5 ± 925.7 ± 15
Type of tumor216PAC34.1%0.04226.7%0.0746.7%0.4215.9%0.4350.40316.2%0.09269.8 ± 1830.094
PAC/NPCNPC46.9%37.0%4.9%7.4%25.7%83.5 ± 127
Amylase level187No compl.21.3 ± 62.10.000124.0 ± 730.000168.6 ± 1750.33372.3 ± 180-0.77372.5 ± 1770.000122.2 ± 700.000169.8 ± 1830.640
(ukat/l)Compl.150.6 ± 252179.9 ± 270128.1 ± 19962.5 ± 1001.1 ± 1260 ± 31083.5 ± 127
Amylase187< 720.2%0.000111.4%0.00013.5%0.0221.7%0.00010.52919.1%0.000135.6%0.033
(>7 ukat/l)> 769.8%61.6%12.7%60.3%100%57.7%
PF C187No PF C33.1%0.000123.7%0.00013%0.00010.3180.81810.7%0.0001-0.464
(yes/no)PF C100%100%38.9%100%
PF B187No PF B33.1%0.000123.7%0.00016.5%0.6760.3180.81810.7%0.0001-0.221
(yes/no)PF B100%100%5.6%100%
PF A187No PF A42.5%0.03536.3%0.00010.1480.1710.73424%0.0001-0.141
(yes/no)PF A22.2%0100%
PF B or C187No PF B+C25.2%.0.000114.6%0.00012.6%0.00010.0880.655
PF B+C100%100%22.2
Period of the study240P135.4%0.38325.0%0.1552.1%0.0365.2%0.4850.23016.9%0.29217.70.137
P238.2%31.9%8.3%6.3%21.2%11.8
Hospital stay24014.2 ± 40.000115.2 ± 60.000119.3 ± 130.00318.1 ± 90.000119.6 ± 130.07517.8 ± 120.000118.4 ± 120.0001
(days)31.4 ± 1632.9 ± 1731.9 ± 844.9 ± 2929 ± 1030.7 ± 930.9 ± 10

General complications in 240 operated patients

Type of all general complications (n = 240)n%% 90-day mortality
No general complications20284.25.0
Pneumonia83.325
Cardiorespiratory decompensation31.3100
Heart failure93.811.1
Pulmonary embolism41.725
Different infections104.210
Renal failure1.4100
Brain stroke1.40
Miscellaneous2.80
Total240100.07.9

Indications for pancreatic resection

Indication for pancreatic resectionP1P2Allp
(n/ %)(n/ %)(n/ %)
Pancreatic adeno carcinoma6471135
66.7%50.0%56.7%
Neuroendocrine tumor of the pancreas279
2.1%4.9%3.8%
Main duct intraductal papillary mucinous neoplasm033
0.0%1.4%0.8%
Franz’s tumor101
1.0%0.0%0.4%
Non-Hodgkin lymphoma of the pancreas112
1.0%0.7%0.8%
Adenocarcinoma of the distal bile duct133043
13.5%20.8%17.9%
Adenocarcinoma of the papilla Vateri121830
12.5%12.5%12.5%
Duodenal adenocarcinoma268
2.1%4.2%3.3%
Gastric cancer022
0.0%1.4%0.8%
Chronic pancreatitis167
1.0%4.2%2.9%
DOI: https://doi.org/10.1515/raon-2017-0036 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 54 - 64
Submitted on: Jun 11, 2017
|
Accepted on: Aug 9, 2017
|
Published on: Sep 14, 2017
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2017 Stojan Potrc, Arpad Ivanecz, Vid Pivec, Urska Marolt, Sasa Rudolf, Bojan Iljevec, Tomaz Jagric, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.