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Journal of Gastrointestinal Surgery

, Volume 19, Issue 6, pp 1072–1077 | Cite as

Morbidity and Mortality of Pancreaticoduodenectomy for Benign and Premalignant Pancreatic Neoplasms

  • Timothy E. Newhook
  • Damien J. LaPar
  • James M. Lindberg
  • Todd W. Bauer
  • Reid B. Adams
  • Victor M. ZaydfudimEmail author
Original Article

Abstract

Objectives

Patients with benign neoplasms of the pancreas are selected for pancreaticoduodenectomy if there is concern for malignant transformation. This study compares outcomes after pancreaticoduodenectomy for patients with premalignant and malignant pancreatic neoplasms.

Study Design

This retrospective cohort study included all patients who underwent pancreaticoduodenectomy for histologically confirmed benign/premalignant pancreatic neoplasms and primary pancreatic malignancy reported to National Surgical Quality Improvement Program (NSQIP) from 2005 to 2011. Patient characteristics, intraoperative and postoperative morbidity and mortality were compared.

Results

A total of 6085 patients underwent pancreaticoduodenectomy: 744 (12.2 %) for benign/premalignant and 5341 (87.8 %) for malignant pancreatic neoplasms. Patients with benign/premalignant neoplasms were more commonly female, had lower American Society of Anesthesiologists (ASA) class, and were less likely to have major comorbidities (all p ≤ 0.003). After resection, patients with benign/premalignant neoplasms were more likely to develop organ space infection (13.4 vs. 8.5 %, p < 0.001) and sepsis (12.2 vs. 9.2 %, p = 0.009). Cardiovascular, pulmonary, renal, and other organ system complications (p = 0.12) as well as 30-day mortality (3.0 vs. 2.0 %, p = 0.128) did not differ.

Conclusions

Organ space infection and sepsis are more common after pancreaticoduodenectomy for benign/premalignant neoplasms. Planned improvements in NSQIP data capture should allow for better measurement of this morbidity. A carefully balanced risk and benefit discussion should precede resection in these patients.

Keywords

Pancreaticoduodenectomy Pancreatic neoplasms IPMN Pancreatic adenocarcinoma NSQIP 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Timothy E. Newhook
    • 1
  • Damien J. LaPar
    • 1
  • James M. Lindberg
    • 1
  • Todd W. Bauer
    • 1
  • Reid B. Adams
    • 1
  • Victor M. Zaydfudim
    • 1
    Email author
  1. 1.Section of Hepatobiliary and Pancreatic Surgery, Department of SurgeryUniversity of Virginia Health SystemCharlottesvilleUSA

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