Pancreaticoduodenectomy. A 40-year experience

Area of Science:

• Gastroenterology
• Surgical Oncology
• Hepatobiliary Surgery

Background:

• Pancreaticoduodenectomy (Whipple procedure) is a complex surgery for periampullary tumors.
• Survival rates vary significantly based on tumor type and patient factors.
• Identifying prognostic indicators is crucial for surgical decision-making.

Purpose of the Study:

• To retrospectively analyze survival outcomes following pancreaticoduodenectomy.
• To identify prognostic factors influencing patient survival.
• To evaluate the efficacy of pancreaticoduodenectomy for various periampullary lesions.

Main Methods:

• Retrospective review of 106 pancreaticoduodenectomies.
• Analysis of 51 potential prognostic factors.
• Statistical analysis of survival data based on final pathologic diagnosis.

Main Results:

• Five-year survival rates: 0% for pancreatic adenocarcinoma, 38% for duodenal carcinoma, 30% for ampullary carcinoma, and 100% for benign disease.
• Significant poor prognostic factors identified: age >51, serum bilirubin >6 mg/dl, SGOT >100, and prior drainage procedure.
• Pancreaticoduodenectomy showed limited indications for pancreatic adenocarcinoma.

Conclusions:

• Pancreaticoduodenectomy is the procedure of choice for benign periampullary lesions and suspicious lesions with negative biopsies.
• The procedure has limited indications for adenocarcinoma of the pancreas.
• Prognostic factors significantly impact survival outcomes in patients undergoing pancreaticoduodenectomy.