Abstract
to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. we prospectively studied 50 consecutive patients undergoing pancreatic resections for peri-ampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. patients' age ranged between 16 and 90 years (average: 53.3). We found anemia (Hb < 12g/dl) and preoperative jaundice in 38% and 40% of cases, respectively. Most patients presented with peri-ampullary tumors (66%). The most common surgical procedure was the Kausch - Whipple operation (70%). Six patients (12%) needed to undergo resection of a segment of the mesenteric-portal axis. The mean operative time was 445.1 minutes. Twenty two patients (44%) showed no clinical complications and presented mean hospital stay of 10.3 days. The most frequent complications were pancreatic fistula (56%), delayed gastric emptying (17.1%) and bleeding (16%). within the last three decades, pancreatic resection is still considered a challenge, especially outside large specialized centers. Nevertheless, even in our country (Brazil), teams seasoned in such procedure can reach low mortality rates.
Highlights
Pancreatic resection is still a complex procedure
In Brazil, few publications are devoted to the overall results of pancreatectomy performed for various diseases in the same service or the same group of surgeons
Mortality rates found in national publications by the year 2012 ranged between 4.3% and 21.9%8-14, being superior to those described in the international literature[3]
Summary
Pancreatic resection is still a complex procedure. described in the first half of the twentieth century, the cephalic resection of the pancreas was infrequently practiced because of poor early results[1]. Mortality of around 25% with pancreaticoduodenectomy was frequent, which raised doubts about the implementation of this operation in the treatment of pancreas adenocarcinoma[1]. It was not until the 60s, with a pioneer creation of specialized services for the treatment of pancreatic diseases, that the John Hopkins Hospital in Baltimore, under the leadership of John Cameron, achieved better results[2]. In major centers the procedure is routinely performed; its indications for some pre-malignant diseases, or even benign ones, have become accepted; the length of stay has become smaller; and, above all, the mortality rate has become less than 3%3
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