(1) Cedars-Sinai Medical Center, Department of Abdominal Transplant and Hepatopancreaticobiliary Surgery, Los Angeles, 90048, CA, USA
(2) University of Illinois, Department of Surgery, Chicago, 60612, USA
(3) Emory University, Department of Surgery, Atlanta, 30322, USA
* Corresponding author Email: alagappan.annamalai@cshs.org
Introduction
Pancreaticoduodenectomy is associated with significant post-operative morbidity and mortality. Identifying the pre-operative factors that increase the risk of post-operative morbidity might improve patient selection and risk stratification, and may lead to better outcomes. The aim of this article was to evaluate the predictors of mortality following pancreaticoduodenectomy for periampullary cancer.
Materials and Methods
Using the American College of Surgeons–National Surgical Quality Improvement Project’s participant-use file, we identified all patients who underwent pancreaticoduodenectomy (Whipple) for periampullary cancer at the 240 participating hospitals. Demographic, clinical and intra-operative variables and 30-day morbidity and mortality were collected in standardised fashion.
Results
From the 2005 to 2008 databases, we identified 3072 patients who underwent pancreaticoduodenectomy. The 30-day mortality following Whipple was 3% (92/3072). Pre-operative factors leading to increased risk of mortality included: age >55 years (OR 2.65,
Conclusion
Recognising the risk factors pre-operatively may help guide physicians in the management of these patients. Optimising patient selection and risk stratification is crucial in these patients and will likely lead to improved outcomes and quality of life.
