Resectable periampullary tumor in patients with previous pancreatitis. What type of surgical procedure to choose?

Abstract

To evaluate the early outcomes of radical surgical treatment of patients with resectable periampullary tumors and previous acute pancreatitis (AP). A retrospective analysis included 9 patients. AP was diagnosed in all patients at different times of preoperative period (post-manipulative AP in 7 cases, alcoholic AP in 2 cases). Pancreaticoduodenectomy was performed in 5 patients, total pancreatectomy (TP) - in 4 patients. Severe postoperative complications occurred in 3 patients after pancreaticoduodenectomy. There were no complications after TP. All complications after pancreaticoduodenectomy were associated with a pancreatic stump that required urgent surgical interventions. Three patients died from surgical complications. All postoperative deaths were observed after pancreaticoduodenectomy. TP may be a safer surgical option compared to pancreaticoduodenectomy in patients with resectable periampiullary tumors and preoperative AP.