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Reoperation following Pancreaticoduodenectomy

Authors: J. R. Reddy; R. Saxena; R. K. Singh; B. Pottakkat; A. Prakash; A. Behari; A. K. Gupta; +1 Authors

Reoperation following Pancreaticoduodenectomy

Abstract

Introduction. The literature on reoperation following pancreaticoduodenectomy is sparse and does not address all concerns.Aim. To analyze the incidence, causes, and outcome of patients undergoing reoperations following pancreaticoduodenectomy.Methods. Retrospective analysis of 520 consecutive patients undergoing pancreaticoduodenectomy from May 1989 to September 2010.Results. 96 patients (18.5%) were reoperated; 72 were early, 18 were late, and 6 underwent both early and late reoperations. Indications for early reoperation were post pancreatectomy hemorrhage in 53 (68%), pancreatico-enteric anastomotic leak in 10 (13%), hepaticojejunostomy leak in 3 (3.8%), duodenojejunostomy leak in 4 (5%), intestinal obstruction in 1 (1.2%) and miscellaneous causes in 7 (9%). Patients reoperated early did not fare poorly on long-term follow up. Indications for late reoperations were complications of index surgery (n= 12), recurrence of the primary disease (n= 8), complications of adjuvant radiotherapy (n= 3), and gastrointestinal bleed (n= 1). The median survival of 16 patients reoperated late without recurrent disease was 49 months.Conclusion. Early reoperations following pancreaticoduodenectomy, commonly for post pancreatectomy hemorrhage, carries a high mortality due to associated sepsis, but has no impact on long-term survival. Long-term complications related to pancreaticoduodenectomy and adjuvant radiotherapy can be managed successfully with good results.

Keywords

Clinical Study

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Average
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Average
Top 10%
Top 10%
Green
gold