Skip to main content

Advertisement

Log in

Pancreaticoduodenectomy in a Government Medical College—Should We Proceed!!!

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The value of standard Pancreaticoduodenectomy for Periampullary carcinomas has long been a matter of debate. Though the mortality has dramatically reduced in high volume centers with dedicated hepatobiliary surgery units, the rate is still high in peripheral institutes. In this study our aim was to access the overall post operative outcome associated with pancreaticoduodenectomy performed in a government medical college. A total of 44 patients who underwent pancreaticoduodenectomy for operable periampullary cancers were evaluated. The overall morbidity rate was 31.1%. A total of 13 (29.5%) died following the operation and of its complications though the rate has reduced drastically to 14.2% in2008. The average length of hospital stay was 22 days. The mean survival was 15 months. Pancreaticoduodenectomy can safely be performed in government medical colleges with good results. In view of the majority of the patients in rural and suburban communities, not all patients need referral to higher centers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Graph 1

Similar content being viewed by others

References

  1. Crile G (1970) The advantages of bypass operations over radical pancreaticoduodenectomy in the treatment of pancreatic carcinoma. Surg Gynecol Obstet 130:1049

    PubMed  Google Scholar 

  2. Yeo CJ, Sohn TA, Cameron JL et al (1998) Periampullary adenocarcinomas; analysis of 5yr survivors. Ann Surg 227:821–831

    Article  PubMed  CAS  Google Scholar 

  3. Yeo C, Cameron JL, Sohn TA, et al (1997) Six hundred fifty consecutive pancreaticoduodenectomies. Pathology,complications,outcomes. Ann Surg 248–260

  4. Birkmeyer JD, Siewers AE, Finlayson EVA et al (2002) Hospital volume and surgical mortality in the United States. N Engl J Med 346:1128–1137

    Article  PubMed  Google Scholar 

  5. Birkmeyer JD, Warshaw AL, Finlayson SR et al (1999) Relationship between hospital volume and late survival after pancreaticoduodenectomy. Surgery 126:178–183

    Article  PubMed  CAS  Google Scholar 

  6. Edge SB, Schmieg RE, Rosenlof LK et al (1993) Pancreas cancer resection outcome in American university centers. Cancer 71:3502–3508

    Article  PubMed  CAS  Google Scholar 

  7. Balcom JH, Rattner DW, Warshaw AL et al (2001) Ten-year experience with 733 resections: changing indications, older patients, and decreasing length of hospitalization. Arch Surg 136:391–398

    Article  PubMed  Google Scholar 

  8. Sohn TA, Yeo CJ, Cameron JL et al (2000) Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 4:567–579

    Article  PubMed  CAS  Google Scholar 

  9. Wade TP, Radford DM, Virgo KS et al (1994) Complications and outcomes in the treatment of pancreatic adenocarcinoma in the United States veteran. J Am Coll Surg 179:38–48

    PubMed  CAS  Google Scholar 

  10. Jagannath P, Shrikhande SV (2003) Current options in the diagnosis and management of periampullary carcinoma. Ind J Surg 65:347–353

    Google Scholar 

  11. Maingots abdominal operations, 11th ed, cancers of pancreas and other periampullary cancers,ch 41:pp 1032–1034

  12. Yeo et al (Sep, 1997) Ann Surg 226(3):248–257

  13. Yeo CJ, Barry MK, Sauter PK et al (1993) Erythromycin accelerates gastric emptying following pancreaticoduodenecomy: a prospective, randomised placebo controlled trial. Ann Surg 218:229

    Article  PubMed  CAS  Google Scholar 

  14. Cullen JJ, Sarr MG, Ilstrup D (1994) Pancreatic anastomotic leak after pancreaticoduodenectomy; incidence, significance and management. Am J Surg 168:295–298

    Article  PubMed  CAS  Google Scholar 

  15. Lin JW, Cameron JL, Yeo CJ et al (2004) Risk factors and outcomes in post pancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg 8:951–959

    Article  PubMed  Google Scholar 

  16. Bassi C, Dervenis C, Butturini G et al (2005) Post operative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138:8–13

    Article  PubMed  Google Scholar 

  17. Van Berge Henegouwen MI, De Wit LT, Gouma DJ et al (1997) Incidence, risk factors, and treatment of pancreatic leakage after pancreaticoduodenectomy: drainage versus resection of the pancreatic remnant. J Am Coll Surg 185:18–24

    PubMed  Google Scholar 

  18. Yang Y-M, Tian X-D, Zhuang Y et al (2005) Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol 11:2456–2461

    PubMed  Google Scholar 

  19. Shrikhande SV, Friess H, Buchler MW (2008) Surgery of pancreatic tumors 15:167

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Devi Prasad Patra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Patra, D.P., Basu, A., De, S. et al. Pancreaticoduodenectomy in a Government Medical College—Should We Proceed!!!. Indian J Surg 72, 381–385 (2010). https://doi.org/10.1007/s12262-010-0153-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-010-0153-x

Keywords

Navigation