Pancreaticojejunostomy anastomosis techniques after pancreaticoduodenectomy: a critical review

Aziret, Mehmet

doi:10.14744/etd.2021.26628

Cited by 1 publication

(4 citation statements)

References 30 publications

(74 reference statements)

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“…The expanding elderly population is predicted to significantly affect surgical practice, and there has been a 25-30% increase in general surgeries performed over the past two decades, coinciding with a consistent increase in the number of geriatric cancers [1,7]. Despite the PD or Whipple procedure representing a curative treatment modality in periampullary tumors, this procedure is accompanied by high morbidity and mortality rates [7,10,11]. In elderly patients, the rate of dramatic complications may be double, even when surgeries are performed at high-volume centers.…”

Section: Discussionmentioning

confidence: 99%

“…In elderly patients, the rate of dramatic complications may be double, even when surgeries are performed at high-volume centers. According to existing literature, mortality may occur following PD due to multiple risk factors, including patient characteristics, perioperative conditions, and the experience of the surgeon or medical center [7,12,18,21,22,23,24]. PFAO is a significant risk factor, with hospital mortality rates for grade B and C patients as high as 25% [7,19].…”

Section: Discussionmentioning

confidence: 99%

“…According to existing literature, mortality may occur following PD due to multiple risk factors, including patient characteristics, perioperative conditions, and the experience of the surgeon or medical center [7,12,18,21,22,23,24]. PFAO is a significant risk factor, with hospital mortality rates for grade B and C patients as high as 25% [7,19]. Various studies have reported a mortality rate of 1.6-2.5 times greater in elderly patients who underwent pancreatic surgery, particularly notable in the centralization of procedures in high-volume hospitals [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…In 2022 alone, approximately 62,210 new diagnoses were reported among adults in the USA, resulting in 49,830 deaths across genders [6]. Pancreaticoduodenectomy (PD) is a complex surgical tech-nique primarily used to remove periampullary tumors or masses [5,6,7]. However, the Coronavirus disease-19 (COVID-19) pandemic has recently affected world, especially in the health field, with highly damaging results.…”

Section: Introductionmentioning

confidence: 99%

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Early and Long-Term Morbidity and Mortality Following Pancreaticoduodenectomy for Periampullary Tumors in Elderly Patients

Aziret,

Aşıkuzunoğlu,

Altıntoprak

et al. 2024

Ann Ital Chir

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Aim: The growing elderly population is facing an increasing risk of cancers, consequently raising the pancreatic cancer surgery rate. This study aimed to determine whether advanced age is a risk factor for morbidity and mortality following pancreaticoduodenectomy (PD) for periampullary tumors. Materials and Methods: The present study included 90 patients who underwent PD for periampullary tumors. Patients were divided into two age-related groups, including those aged 60–74 years (n = 60) (Group 1) and those aged ≥75 years (n = 30) (Group 2). Each patient's characteristics, perioperative features, morbidity, and long-term results were evaluated retrospectively. Results: In both univariate and multivariate logistic regression analyses, old age (≥75 years) was not a risk factor for morbidity and hospital mortality. The multivariate analysis demonstrated that male gender (p = 0.008), pancreatic duct diameter (<3 mm) (p < 0.001), and length of hospital stay (p = 0.005) were independent risk factors for pancreatic fistula post-operation and reoperation. Additionally, hospital mortality was significantly associated with reoperation (p = 0.011). The overall median survival was 27 ± 4.1 (18.8–35.1) months. Lymph node positivity (p < 0.001), neural tumor invasion (p = 0.026), and age ≥75 years (p = 0.045) were risk factors affecting the overall survival rate. Moreover, there was no statistically significant difference in terms of PD rates during the Coronavirus disease-19 (COVID-19) period among groups, and PD during this period was not related to the occurrence of pancreatic fistula. Conclusion: PD can be performed effectively in selected elderly patients with tolerable morbidity and mortality rates.

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