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147 Pancreatoduodenectomies: a Single Center’s Perspective into the Epidemiology and Surgical Outcomes of Periampullary and Pancreatic Cancers in South India

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Abstract

Background

Pancreatoduodenectomy (PD) is the only curative procedure for resectable periampullary cancers. This study aims to survey the various outcome variables of the procedure at our institute, which is in the early process of evolving into a high-volume center for PDs.

Methods

Data of patients, who underwent PDs, was collected retrospectively from January 2010 to December 2017 and prospectively from January 2018 to December 2019. Various preoperative, intraoperative, and histopathological parameters were compared with the outcome variables—morbidity and mortality rates.

Results

A total of 147 patients underwent PDs over the last decade. From January 2010 to December 2014 (period A), 29 patients underwent PD, while 118 patients underwent PD from January 2015 to December 2019 (period B). Clinically relevant (CR) delayed gastric emptying (44.8% vs 23.7%), CR post-pancreatectomy hemorrhage (37.9% vs 18.6%), and blood loss (850 ml (400–5300 ml) vs 600 ml (150–2500 ml)) improved in period B with no improvement in CR postoperative pancreatic fistula (20.7% vs 28.8%). The rates of SSI (63.6%), pulmonary complications (29.9%), and mean postoperative stay (19.87 ± 11.59 days) were found to be higher than most of the major centers. Mortality rates decreased significantly from 27.6% in period A to 10.2% in period B (p = 0.029). Median overall survival was 30 months (95% CI 20.76–39.23 months)

Conclusion

Over the last decade, there has been a significant improvement in the mortality rate, but morbidity remains high and must be looked into as the department enters the new decade as a young high-volume center.

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Authors and Affiliations

  1. Division of GI & HPB Surgery, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Souradeep Dutta, Ankit Jain, Reddy Abhinaya & Vishnu Prasad Nelamangala Ramakrishnaiah

  2. Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Thirthar Palanivelu Elamurugan

  3. Department of Medical Oncology, Regional Cancer Centre, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Biswajit Dubashi

  4. Department of Radiation Oncology, Regional Cancer Centre, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Karunanithi Gunaseelan

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  1. Souradeep Dutta
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Correspondence to Vishnu Prasad Nelamangala Ramakrishnaiah.

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Ethical Approval and Consent to Participate

Informed written consent and permission were obtained from all the patients for the use of the clinical data for the purpose of study and publication. The study protocol was in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration. The study was approved by institutional ethics committee (JIP/IEC/2017/0490).

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Dutta, S., Elamurugan, T.P., Dubashi, B. et al. 147 Pancreatoduodenectomies: a Single Center’s Perspective into the Epidemiology and Surgical Outcomes of Periampullary and Pancreatic Cancers in South India. J Gastrointest Canc 52, 1035–1045 (2021). https://doi.org/10.1007/s12029-020-00534-5

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