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Risk factors for complications after pancreatic head resection
Ulrich Adam1, Frank Makowiec, Hartwig Riediger
1Department of Surgery, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany. ulrich.adam@chir.ukl-freiburg.de
Background:
Postoperative morbidity is high after pancreatic head resections. Data about risk factors are controversial. The aim of this study was to evaluate risk factors for complications after pancreatic head resection and to assess whether the complication rate changed during the study period.
Methods:
Data of 301 patients undergoing pancreatic head resection were recorded prospectively. Risk factors were assessed by multivariate analysis. The first and second part of the study period were compared.
Results:
Mortality was 3%. Overall and surgery-related complications occurred in 42% and 28%, respectively. Independent risk factors for postoperative morbidity were impaired renal function (odds ratio [OR] 2.7), absence of preoperative biliary drainage (OR 1.9), and resection of other organs (OR 3.2). Complication rate, duration of surgery, amount of blood transfused, and length of hospital stay decreased during the study period.
Conclusions:
Increasing hospital experience decreased complication rates. Patients with risk factors should be considered for transferal to specialized centers.