Outcomes of Surgical Technique in Postoperative Complications after Pancreatoduodenectomy

Abstract

Introduction: The aim of this work was to analyse the association between surgical aspects such as the pancreas texture, Wirsung diameter, use of barbed suture and operative total blood loss with postoperative complications after pancreatoduodenectomy (PD). Methods: Patients who underwent PD between December 2014 and October 2020 were selected. During the surgical intervention pancreas texture (soft or hard), Wirsung diameter (<3 mm or > 3 mm), use of barbed suture (use of barbed suture or not used) and operative total blood loss (< 700cc or > 700cc) were collected. Overall postoperative complications (according to Clavien’s classification), major complications (Clavien≥III), postoperative pancreatic fistula (POPF) and postpancreatectomy hemorrhage were registered up to discharge. Chi-Square for discrete variables was used for univariate analysis. Results: Finally, 95 patients were eligible for statistical analysis. After carrying out the univariate analysis, overall complications were related to the use of barbed suture (67.7% vs 89.7%; p-value=0.032). The reintervention rate was significantly associated with the Wirsung diameter (7.1% vs 23.1%; p-value=0.026). Pancreas texture and operative total blood loss did not show any statistical significant at the analysis of global or specific postoperative complications. Conclusions: The results of our work showed that the use of barbed suture was strongly associated with major overall complications after PD. Also, Wirsung diameter was significantly associated with the rate of reintervention. No statistical differences were found in pancreas texture or total blood loss.