Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 175] Clinico Pathological Profile, Surgical Outcome And Survival Analysis after Pancreaticoduodenectomy: 7 Year Experience from Tertiary Care Teaching Hospital in Odisha
Dr. Swamy Rajesh HUDUGUR 1, Dr. Satyaprakash RAY CHUDHURY 1, Dr. Jyotirmay JENA 1, Dr. Sumit S MOHANTY 1
1 Department of Surgical Gastroenterology , IMS & SUM Hospital , INDIA
Background : Despite advances in multimodality treatment, morbidity after pancreaticoduodenectomy (PD) remains high. This study aimed to analyze the clinico-pathological profile, surgical outcomes, and survival of patients undergoing PD in a single tertiary care center.
Methods : Retrospective analysis was conducted using prospectively compiled data from 2016 to 2022. Patients who underwent PD and completed one year of follow-up were included. Survival analysis was performed using Kaplan-Meier analysis.
Results : Of 104 patients who underwent PD, age range was 15 to 77 years (median: 53), with most being male (61.5%) and having CCI score - 0 (77.9%). Jaundice was the common presenting complaint. Preoperative stenting was performed in 47% of patients mainly for cholangitis. Most patients underwent pancreaticojejunostomy(92%). Total morbidity was 77.1%, with pancreatic fistula (62.5%) as most common complication, followed by delayed gastric emptying (35.6%). Postoperative hemorrhage()7%, bile leak(5.8%), and surgical site infection(18%) were also observed. The 30-day and 90-day mortality rates were 3.8% and 9.6%, respectively. Adenocarcinoma was the most common histopathological finding (79.8%), followed by benign disease. Most adenocarcinomas were T3 stage (49.3%) with no lymph node involvement(62%) (N1: 26.5%). Only 66.2% of adenocarcinoma patients received or were on chemotherapy. The median survival for adenocarcinoma was 45 months, with no significant difference among subtypes. However, significant survival improvement was observed in patients who received chemotherapy. The one-year, three-year, and five-year survival rates were 79.4%, 51.2%, and 35.7%, respectively.
Conclusions : Pancreaticoduodenectomy remains a high-risk surgery with significant morbidity and mortality. Adenocarcinoma was the most common diagnosis, and chemotherapy showed a significant survival benefit.
Methods : Retrospective analysis was conducted using prospectively compiled data from 2016 to 2022. Patients who underwent PD and completed one year of follow-up were included. Survival analysis was performed using Kaplan-Meier analysis.
Results : Of 104 patients who underwent PD, age range was 15 to 77 years (median: 53), with most being male (61.5%) and having CCI score - 0 (77.9%). Jaundice was the common presenting complaint. Preoperative stenting was performed in 47% of patients mainly for cholangitis. Most patients underwent pancreaticojejunostomy(92%). Total morbidity was 77.1%, with pancreatic fistula (62.5%) as most common complication, followed by delayed gastric emptying (35.6%). Postoperative hemorrhage()7%, bile leak(5.8%), and surgical site infection(18%) were also observed. The 30-day and 90-day mortality rates were 3.8% and 9.6%, respectively. Adenocarcinoma was the most common histopathological finding (79.8%), followed by benign disease. Most adenocarcinomas were T3 stage (49.3%) with no lymph node involvement(62%) (N1: 26.5%). Only 66.2% of adenocarcinoma patients received or were on chemotherapy. The median survival for adenocarcinoma was 45 months, with no significant difference among subtypes. However, significant survival improvement was observed in patients who received chemotherapy. The one-year, three-year, and five-year survival rates were 79.4%, 51.2%, and 35.7%, respectively.
Conclusions : Pancreaticoduodenectomy remains a high-risk surgery with significant morbidity and mortality. Adenocarcinoma was the most common diagnosis, and chemotherapy showed a significant survival benefit.
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E-poster
E-Session 03/21 ALL DAY