Hong Kong Med J 2002;8:249-54 | Number 4, August 2002
Standards of pancreaticoduodenectomy in a tertiary referral centre in Hong Kong: retrospective case series
RTP Poon, ST Fan, KM Chu, JTC Poon, J Wong
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
OBJECTIVE. To evaluate the perioperative outcomes of pancreaticoduodenectomy in a tertiary referral centre in Hong Kong.
DESIGN. Retrospective case series.
SETTING. University teaching hospital, Hong Kong.
PATIENTS. One hundred and forty patients who underwent pancreaticoduodenectomy from July 1989 through June 2001.
MAIN OUTCOME MEASURES. Mortality and morbidity.
RESULTS. Overall hospital mortality among 140 patients was 2.9% (n=4), and 30-day operative mortality was 2.1% (n=3). There was no significant difference in the hospital mortality rate between 43 elderly patients aged 70 years or older and 97 younger patients (2.3% versus 3.1%). The overall morbidity rate was 38.6% (n=54). Intra-abdominal abscess (13.6%) and pancreaticojejunal anastomotic leakage (12.9%) were the two most common complications. Presence of co-morbid illness (risk ratio, 2.823; 95% confidence interval, 1.541-4.385; P=0.01), preoperative cholangitis (risk ratio, 2.565; 95% confidence interval, 1.166-5.643; P=0.02), and intra-operative blood loss ?.5 L (risk ratio, 2.236; 95% confidence interval, 1.132-6.213; P=0.03) were independent risk factors for postoperative morbidity.
CONCLUSIONS. Pancreaticoduodenectomy is associated with a low risk of operative death when performed in a tertiary referral setting in Hong Kong. The postoperative morbidity rate remains high, however. Further improvement by reducing intra-operative blood loss may help curtail the high postoperative morbidity.
Key words: Morbidity; Mortality; Pancreaticoduodenectomy
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