FACTORS ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS AFTER PANCREATODUODENECTOMY (WHIPPLE PROCEDURE) IN A SPECIALIZED CENTER

FACTORES ASOCIADOS A COMPLICACIONES DESPUÉS DE DUODENOPANCREATECTOMÍA CEFÁLICA (CIRUGÍA DE WHIPPLE) EN UN CENTRO ESPECIALIZADO

Authors

  • Jorge Cornejo Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
  • Lucy E. Correa López Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
  • Jose Cornejo Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
  • Mariela Vargas Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
  • Belkys Figueroa Depablos Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
  • Cesar Rodríguez Servicio Cirugía de Páncreas, Hospital Edgardo Rebagliati Martins. Lima, Perú.

DOI:

https://doi.org/10.25176/RFMH.v23i4.6031

Keywords:

Peru, Associated factors, Postoperative complications, Pancreatoduodenectomy

Abstract

ABSTRACT

Introduction: Whipple procedure, also known as pancreatoduodenectomy (PD), is a widely used procedure for several types of peri-ampullary cancer. Objectives: To establish the factors associated with postoperative complications after PD in the Pancreas Surgery Service of the Edgardo Rebagliati Martins National Hospital in Lima, Peru.
Methods: An observational, quantitative, analytical, cross-sectional, and retrospective study was carried out on 81 patients during the period from January 2017 to December 2019, who underwent PD. The dependent variable was postoperative complications and the independent variables were preoperative, perioperative, and postoperative variables. The medical records were reviewed. Logistic regression was performed to find the crude and adjusted ORs.
Results: The mean age was 65.97±10.14 and the majority of patients were male. The most common postoperative complication was pancreatic fistula (34.6%). Factors associated with postoperative complications after PD were male sex (aOR: 4.46, 95% CI: 1.35-14.77), ampullary cancer (aOR: 6.92, 95% CI: 1.75-27.48), and soft consistency of the pancreas (aOR: 4.52, 95% CI: 0.07-0.58).
Conclusions: The factors associated with postoperative complications after PD were male sex, ampulloma, and soft consistency of the pancreas.

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References

Fernandez-Cruz L, Sabater L, Fabregat J. Complicaciones después de una pancreaticoduodenectomía. CIR ESP. 2012;4:222–32. doi:10.1016/j.ciresp.2011.04.026

Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J. Schwartz’s Principles Of Surgery. Tenth. New York: McGraw-Hill Education; 2014.

Aguller JAG, Barroso DR, Fernández ZR, Costa OV, García AL, García LIR. Morbilidad y mortalidad de la duodenopancreatectomía cefálica convencional en pacientes con enfermedad del confluente biliopancreático. Revista Cubana de Medicina Militar. 2023;52(1):02302318.

Targarona J, Callacondo D, Pino C, Rodriguez C, Coayla G, Garatea R, et al. Impacto de la duodenopancreatectomía en los pacientes adultos mayores. Revista de Gastroenterología del Perú. 2013;217–22. doi:10.47892/rgp.2013.333.204

Dusch N, Lietzmann A, Barthels F, Niedergethmann M, Rückert F, Wilhelm TJ. International Study Group of Pancreatic Surgery Definitions for Postpancreatectomy Complications: Applicability at a High-Volume Center. Scand J Surg. 2017;106(3):216–23. doi:10.1177/1457496916680944

Byrling J, Andersson R, Sasor A, Lindell G, Ansari D, Nilsson J, et al. Outcome and evaluation of prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma. Ann Gastroenterol. 2017;30(5):571–7. doi:10.20524/aog.2017.0169

Acosta Jara JL. Complicaciones después de una duodenopancreatectomía en un centro especializado del Hospital Edgardo Rebagliati Martins en el año 2016. Perú: Universidad Nacional Mayor de San marcos; 2017 [citado el 2 de octubre de 2023]. Disponible en: https://cybertesis.unmsm.edu.pe/handle/20.500.12672/5848

Zakaria HM, Mohamed A, Alsebaey A, Omar H, ELazab D, Gaballa NK. Prognostic factors following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. International Surgery Journal. 2018;5(12):3877–82. doi:10.18203/2349-2902.isj20185011

Tan C-L, Zhang H, Peng B, Li K-Z. Outcome and costs of laparoscopic pancreaticoduodenectomy during the initial learning curve vs laparotomy. World J Gastroenterol. 2015;21(17):5311–9. doi:10.3748/wjg.v21.i17.5311

Luna Velásquez EJ, Quintero Marín MT, Luna RE. Duodenopancreatectomía cefálica: análisis de los factores condicionantes de morbimortalidad. Vitae: Academia Biomédica Digital. 2017;(69 (Enero-Marzo)):7.

Cruz-Vargas JADL, Correa-Lopez LE, Alatrista-Gutierrez de Bambaren M del S, Sanchez Carlessi HH. Promoviendo la investigación en estudiantes de Medicina y elevando la producción científica en las universidades: experiencia del Curso Taller de Titulación por Tesis. Educ med (Ed impr). 2019;20(4):199–205. doi:https://doi.org/10.1016/j.edumed.2018.06.003

Junrungsee S, Kittivarakul E, Ko-iam W, Lapisatepun W, Sandhu T, Chotirosniramit A. Prognostic Factors and Survival of Patients with Carcinoma of the Ampulla of Vater after Pancreaticoduodenectomy. Asian Pac J Cancer Prev. 2017;18(1):225–9. doi:10.22034/APJCP.2017.18.1.225

Uomo G. Periampullary carcinoma: some important news in histopathology. JOP. 2014;15(2):213–5. doi:10.6092/1590-8577/2421

Distler M, Rückert F, Hunger M, Kersting S, Pilarsky C, Saeger H-D, et al. Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma. BMC Surg. 2013;13:12. doi:10.1186/1471-2482-13-12

Llacta Aparicio D. Características Clínico-Quirúrgicas de pacientes con cáncer periampular sometidos a duodenopancreatectomía cefálica en el Instituto Nacional de Enfermedades Neoplásicas durante el periodo 2002-2011. Perú: Universidad Ricardo Palma; 2016 [citado el 28 de octubre de 2023]. Disponible en: https://repositorio.urp.edu.pe/handle/20.500.14138/542

Pugalenthi A, Protic M, Gonen M, Kingham TP, Angelica MID, Dematteo RP, et al. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016;113(2):188–93. doi:10.1002/jso.24125

Dokmak S, Ftériche FS, Aussilhou B, Bensafta Y, Lévy P, Ruszniewski P, et al. Laparoscopic pancreaticoduodenectomy should not be routine for resection of periampullary tumors. J Am Coll Surg. 2015;220(5):831–8. doi:10.1016/j.jamcollsurg.2014.12.052

Aoki S, Miyata H, Konno H, Gotoh M, Motoi F, Kumamaru H, et al. Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan. J Hepatobiliary Pancreat Sci. 2017;24(5):243–51. doi:10.1002/jhbp.438

Katzenstein J, Steinert R, Ptok H, Otto R, Gastinger I, Lippert H, et al. [Gender-specific differences of the early postoperative and oncosurgical long-term outcome in rectal cancer-data obtained in a prospective multicenter observational study]. Chirurg. 2018;89(6):458–65. doi:10.1007/s00104-018-0634-1

Feng J, Zhou X, Mao W. Prognostic analysis of carcinoma of the ampulla of Vater: pancreaticoduodenectomy versus local resection. Hippokratia. 2012;16(1):23–8.

Yang Y, Fu X, Zhu S, Cai Z, Qiu Y, Mao L. Vater’s ampullary carcinoma increases the risk of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A retrospective and propensity score-matched analysis. BMC Gastroenterol. 2022;22(1):51. doi:10.1186/s12876-022-02128-w

Fu S-J, Shen S-L, Li S-Q, Hu W-J, Hua Y-P, Kuang M, et al. Risk factors and outcomes of postoperative pancreatic fistula after pancreatico-duodenectomy: an audit of 532 consecutive cases. BMC Surgery. 2015;15(1):34. doi:10.1186/s12893-015-0011-7

Rungsakulkij N, Mingphruedhi S, Tangtawee P, Krutsri C, Muangkaew P, Suragul W, et al. Risk factors for pancreatic fistula following pancreaticoduodenectomy: A retrospective study in a Thai tertiary center. World J Gastrointest Surg. 2017;9(12):270–80. doi:10.4240/wjgs.v9.i12.270

Targarona J, Pando E, Vavoulis A, Sequeiros J, Garatea R, Rotta C, et al. Evaluación de los factores condicionantes de Morbi-mortalidad en la Duodenopancreatectomía por Neoplasias Periampulares. Revista de Gastroenterología del Perú. 2008;28(3):226–34. doi:doi.org/10.47892/rgp.2008.283.511

Sarmiento Olazabal MS. Factores de riesgo asociados a fistula pancreatica en pacientes postoperados de duodenopancreatectomia Hospital Edgardo Rebagliati Martins. 2017- 2018. Perú: Universidad Ricardo Palma; 2019 [citado el 8 de octubre de 2023]. Disponible en: https://renati.sunedu.gob.pe/handle/sunedu/3210491

Published

2024-01-03 — Updated on 2024-04-01

How to Cite

Cornejo, J. ., Correa López, L. E., Cornejo, J., Vargas, M., Figueroa Depablos, B., & Rodríguez, C. (2024). FACTORS ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS AFTER PANCREATODUODENECTOMY (WHIPPLE PROCEDURE) IN A SPECIALIZED CENTER: FACTORES ASOCIADOS A COMPLICACIONES DESPUÉS DE DUODENOPANCREATECTOMÍA CEFÁLICA (CIRUGÍA DE WHIPPLE) EN UN CENTRO ESPECIALIZADO. Revista De La Facultad De Medicina Humana, 23(4), 81–91. https://doi.org/10.25176/RFMH.v23i4.6031