Complications Following Pancreaticoduodenectomy: Current Management

Brent W. Miedema, Michael G. Sarr, Jon A. Van Heerden, David M. Nagorney, Donald C. McIlrath, Duane Ilstrup

Research output: Contribution to journalArticle

372 Scopus citations

Abstract

From 1980 to 1989, 279 patients underwent pancreaticoduodenectomy at a single institution with a postoperative mortality of 4%. The aim of this study was to determine incidence, origin, and present management strategy of early complications following this operation. Significant morbidity occurred in 46% of the patients, including delayed gastric emptying (23%), pancreaticojejunal anastomotic leak (17%), intra-abdominal sepsis (10%), biliary-enteric anastomotic leak (9%), gastrointestinal tract bleeding (5%), and intra-abdominal hemorrhage (3%). Complications were associated with advanced age, prolonged operations, and increased operative blood loss. Most complications were managed nonoperatively. Mortality was increased when a reoperation was required, a biliary-enteric leak occurred, or an intra-abdominal abscess developed. Pancreaticoduodenectomy continues to carry a high postoperative morbidity; however, operative mortality is low, and management of complications has been made simpler with more sophisticated, nonoperative therapeutic options.

Original languageEnglish (US)
Pages (from-to)945-950
Number of pages6
JournalArchives of Surgery
Volume127
Issue number8
DOIs
StatePublished - Aug 1992

ASJC Scopus subject areas

  • Surgery

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    Miedema, B. W., Sarr, M. G., Van Heerden, J. A., Nagorney, D. M., McIlrath, D. C., & Ilstrup, D. (1992). Complications Following Pancreaticoduodenectomy: Current Management. Archives of Surgery, 127(8), 945-950. https://doi.org/10.1001/archsurg.1992.01420080079012