Combined pancreaticoduodenectomy and colon resection for locally advanced peri-ampullary tumours: analysis of peri-operative morbidity and mortality

• Published in: HPB (Oxford, England) Vol. 16; no. 9; pp. 797 - 800
• Main Authors: Temple, Sara J, Kim, Peter T.W, Serrano, Pablo E, Kagedan, Daniel, Cleary, Sean P, Moulton, Carol-Anne, McGilvray, Ian D, Gallinger, Steven, Greig, Paul D, Wei, Alice C
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2014; Wiley Subscription Services, Inc; BlackWell Publishing Ltd
• Subjects: Academic Medical Centers; Adult; Aged; Blood Loss, Surgical; Chemotherapy, Adjuvant; Colectomy - adverse effects; Colectomy - mortality; Digestive System Neoplasms - mortality; Digestive System Neoplasms - pathology; Digestive System Neoplasms - surgery; Female; Gastroenterology and Hepatology; Hospitals, High-Volume; Humans; Length of Stay; Male; Middle Aged; Neoadjuvant Therapy; Ontario; Operative Time; Original; Pancreaticoduodenectomy - adverse effects; Pancreaticoduodenectomy - mortality; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - mortality; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Young Adult; Ontario
• ISSN: 1365-182X; 1477-2574
• DOI: 10.1111/hpb.12263

Abstract Background Combined pancreaticoduodenectomy (PD) and colonic resection may be necessary to achieve an R0 resection of peri-ampullary tumours. The aim of this study was to examine the morbidity and mortality associated with this procedure. Methods A retrospective cohort study was performed comparing 607 patients who underwent a standard pancreaticoduodenectomy (S-PD) to 28 patients who had a concomitant colon resection and PD (PD-colon) over a 10-year period at an academic centre. Results Patients in the PD-colon group were more likely to have received neoadjuvant chemotherapy ± radiation (3/28, 11% versus 14/607, 2%, P = 0.024). Operative time was also longer (530 versus 410 min, P < 0.001) and they were more likely to have had portal vein resections (9/28, 32% versus 76/607, 13%, P = 0.007). There was no difference in the intra-operative blood loss, length of stay, or overall complication rates. The PD-colon group had a higher rate of severe post-operative bleeding (4/28, 11% versus 8/607, 1%, P = 0.002). The post-operative mortality rates for the PD-colon and PD groups were 2/28 (7%) and 8/607 (1%), respectively ( P = 0.068). Conclusions PD-colon has an acceptable risk of peri-operative morbidity compared with S-PD in well-selected patients.