PERIOPERATIVE OUTCOMES FOLLOWING PANCREATICODUODENECTOMY: A RETROSPECTIVE REVIEW FROM A DEVELOPING NATION abhishekbhattarai@gmail.com

 

PERIOPERATIVE OUTCOMES FOLLOWING PANCREATICODUODENECTOMY: A RETROSPECTIVE REVIEW FROM A DEVELOPING NATION

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Nepal

Oral only

Despite a dramatic reduction in mortality and morbidity rates following Whipple’s operation in the developed world, perioperative morbidity and mortality remain high in developing nations because of various limiting factors. This study reviews our experience with this procedure over a period of seven years at a single institution.

This is a retrospective review of the patients who underwent pancreaticoduodenectomy for various peri-ampullary pathologies. The study focused on various parameters, including the demographic profile, operative details, disease pathology, postoperative complications, and outcomes.

Out of 170 patients who underwent a Whipple operation during the study period, 54% (n=92) were male. The mean age of presentation was 50.2 years. The most common mode of presentation was obstructive jaundice, observed in 71.76% (n =122). Preoperative biliary drainage was performed in 31.76% (n = 54) of patients. The commonest pathology was ampullary adenocarcinoma, seen in 47.64% (n=81) of patients. A total of 57.64%(n=98) patients developed various complications in the post-operative period, including postoperative pancreatic fistula in 57.64% (n=98), post pancreatectomy haemorrhage in 18.23%(n=31), and delayed gastric emptying in 24.11%(n=41), intra-abdominal collection 9.41 %(n=16) and biliary leakage 6.47%(n=11). A total of 14.7%(n=25) of patients died due to various postoperative complications.

Post-operative complications following pancreaticoduodenectomy are significantly higher in developing countries compared to developed ones. Most of these complications are preventable through improved perioperative care.