• C Fernández-del Castillo, D W Rattner, and A L Warshaw.
• Department of Surgery, Massachusetts General Hospital, Boston, Mass.
• Arch Surg Chicago. 1995 Mar 1;130(3):295-9; discussion 299-300.

ObjectiveTo describe the current indications and operative outcomes of pancreatic resection.DesignRetrospective case series.SettingReferral practice in a university hospital.PatientsTwo hundred thirty-one consecutive patients undergoing pancreatoduodenectomy (PD), distal pancreatectomy (DP), or total pancreatectomy (TP) over a 44-month period. Their ages ranged from 16 to 85 years, with a mean of 54 years; 20% of the patients were 70 years old or older.Main Outcome MeasuresMortality, complications, and length of hospital stay.ResultsOperative mortality was 0.4% (one death following DP); there were no deaths in 142 PDs or in 18 TPs. The most common complication following PD was delayed gastric emptying. Pancreatic fistula occurred in 6.3% of PD and in 9.8% of DP patients. Overall, 58% of PD, 80% of DP, and 78% of TP patients had no complications. The mean +/- SD length of hospital stay was 15 +/- 7, 10 +/- 5, and 15 +/- 6 days for PD, DP, and TP, respectively. Reoperation for any cause was necessary in only 1.2% (3/231). The most frequent indication for PD was pancreatic cancer (36%) followed by chronic pancreatitis (26%); for DP it was chronic pancreatitis (28%) and cystic neoplasms (27%); and for TP, chronic pancreatitis (55%). Newer indications for pancreatic resection included mucinous ductal ectasia and intraductal papillary tumors (eight cases, 4%) and metastatic tumors (eight cases, 4%).ConclusionsCurrent indications for pancreatic resection have expanded. These procedures are associated with a low risk for death and postoperative complications when performed in a high-volume setting.

36 keywords...

hide…