Preoperative Risk Factors Associate with an Increased 30-Day Mortality after Pancreaticoduodenectomy

Abstract

bilirubin. Cirrhotic patients had a lower platelet count (184 vs 252; p ¼ 0.028). Operative times were shorter with smaller tumors (3.3 vs 5.6 cm; p<0.001) and fewer lobar resections (7% vs 26%; p<0.001) resulting in smaller margins (0.857 vs 1.037 cm; p ¼ 0.028) but equivalent local recurrence rate (1.1% vs 2.2%;p ¼ 0.548). Cirrhotic resections required increased resources including ICU and overall length of stay. CONCLUSION: Minimally invasive cirrhotic resection appears to be technically feasible and safe in tertiary centers but should be performed in the appropriate patient population. However, the long-term sequeala of smaller margins will need to be evaluated in long-term oncologic studies. This study should serve as a starting point to a larger and longer cohort or propensity study to support this procedure in this complex area of hepatobiliary surgery.