Perioperative Risk Factors & Outcome After Pancreatico-Duodenectomy (Whipple Procedure)

Mustafa Fakhir, Issam Mardan, A. Dawood
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Abstract

Background: Periampullary cancers have poor prognosis, mainly due to late diagnosis. Although pancreaticoduodenectomy is considered the only possible curative option for these cancers, it is associated with high morbidity and mortality. Aim: To identify the risk factors associated with postoperative morbidity and mortality. Patients and Methods: Data were prospectively collected from the 44 patients who underwent pancreaticoduodenectomy for periampullary cancers in Al-Sader Teaching Hospital, Basrah, Iraq, from June 2017 to June 2020. These variables were reviewed according to developing postoperative morbidity and mortality. The statistical analysis was done using SPSS version 23 and the chi-squared or Fisher’s exact (FE) test. Any level of significance below 0.05 was considered statistically significant. Results: Increased age and the presence of preoperative co-morbidities are independent predictors of developing postoperative morbidity and mortality. The most common postoperative complications leading to mortality are pulmonary embolisms and pancreatic leaks. Conclusion: Improvement in the management of comorbidities and perioperative care are essential in decreasing postoperative morbidity and mortality.
胰十二指肠切除术(Whipple手术)围手术期危险因素及预后
背景:壶腹周围癌预后较差,主要原因是诊断较晚。虽然胰十二指肠切除术被认为是治疗这些癌症的唯一可能选择,但它与高发病率和死亡率有关。目的:探讨与术后发病率和死亡率相关的危险因素。患者和方法:前瞻性收集2017年6月至2020年6月在伊拉克巴士拉Al-Sader教学医院接受胰十二指肠切除术治疗壶腹周围癌的44例患者的数据。根据术后发病率和死亡率对这些变量进行回顾。统计分析使用SPSS 23版和卡方或费雪精确(FE)检验。任何低于0.05的显著性水平都被认为具有统计学意义。结果:年龄的增加和术前合并症的存在是术后发病率和死亡率的独立预测因素。导致死亡的最常见的术后并发症是肺栓塞和胰腺渗漏。结论:改善合并症的管理和围手术期护理对降低术后发病率和死亡率至关重要。
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