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KMID : 0371320000590030291
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Journal of the Korean Surgical Society
2000 Volume.59 No. 3 p.291 ~ p.297
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The Prognostic Significance of Transfusion in Periampullary Cancer Following Pancreatoduodenectomy
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박상재/Sang-Jae Park
김선회/장진영/이건욱/박용현/Sun-Whe Kim/Jin-Young Jang/Kuhn-Uk Lee/Yong-Hyun Park
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Abstract
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Purpose: There are several reports that intraoperative transfusion may be a prognostic factor in periampullary cancer, but it is not conclusive. The purpose of this study is to clarify the prognostic significance of a transfusion following a
pancreatoduodenectomy for periampullary cancers. Methods: We analyzed 357 periampullary cancers from 1985 to 1997 (ampullary cancer: 130 cases; distal bile duct cancer: 141 cases; and pancreatic head cancer: 86 cases). Analytic variables for
possible
prognostic factors were various clinicopathologic factors combined with the presence of the perioperative transfusion. Results: Of the overall 357 patients, 215 (60%) have received an intraoperative transfusion. The 5-year survival rate of the
130
ampullary cancer patients was 59%, and 76 cases (58%) underwent an intraoperative transfusion. The 5-year survival rate of patients without intraoperative transfusion was 79% whereas that of patients with a transfusion was 47% (p=0.029).
Following
multivariate analysis, an intraoperative transfusion was an independent prognostic factor in ampullary cancer (relative risk: 2.174). In common bile duct cancer, the overall 5-year survival rate was 33%, and the 5-year survival rates of patients
with
(N=87) or without (N=54) a transfusion were 25% and 38% respectively, which showed a marginal statistical significance (p=0.0717). In pancreatic head cancer, the overall 5-year survival rate was 16% and there was no survival difference between
transfused (N=52) and untransfused (N=34) patients. Conclusion: In the present study, intraoperative transfusion was an independent significant prognostic factor in ampullary cancer. Careful dissection to minimize intraoperative bleeding is
mandatory in
pancreatoduodenecto
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KEYWORD
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