Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.

Journal Article (Journal Article)

INTRODUCTION: Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40-50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. METHODS: A total of 596 patients that underwent PD for PDA between 2001 and 2009 were identified from a prospective database. Complications were defined and graded (1-5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥grade 3. Postoperative mortality (≤90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. RESULTS: Median survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n = 129). Our 90 day mortality was 3.7% (n = 22). Anastomotic fistula/leak/abscess rate was 14% (n = 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) >600 ml, length of stay (LOS) >10 days, margin positivity, and vascular procedures as predictors of decreased overall survival (P < 0.05). High grade complications were not associated with overall survival (P = 0.948). CONCLUSION: In this study, the occurrence of high grade postoperative complications was not associated with overall survival.

Full Text

Duke Authors

Cited Authors

  • Pugalenthi, A; Protic, M; Gonen, M; Kingham, TP; Angelica, MID; Dematteo, RP; Fong, Y; Jarnagin, WR; Allen, PJ

Published Date

  • February 2016

Published In

Volume / Issue

  • 113 / 2

Start / End Page

  • 188 - 193

PubMed ID

  • 26678349

Pubmed Central ID

  • PMC4830358

Electronic International Standard Serial Number (EISSN)

  • 1096-9098

Digital Object Identifier (DOI)

  • 10.1002/jso.24125


  • eng

Conference Location

  • United States