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KMID : 0371420190970030130
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Annals of Surgical Treatment and Research
2019 Volume.97 No. 3 p.130 ~ p.135
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One hundred sixty pancreaticoduodenectomies for periampullary cancers in a growing-volume setting: a single-institution and a single-surgeon's experience
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Chang Seong-Hwan
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Abstract
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Purpose: Many studies have concluded that cancer patients may have better outcomes when their surgery is performed in high-volume centers, especially when the procedure is pancreaticoduodenectomy (PD). However, some studies concluded that experienced surgeons or incorporation of expertise from high-volume centers may achieve satisfactory outcomes after PD in low-volume centers.
Methods: I retrospectively collected and analyzed the outcomes of PD for periampullary cancers treated with curative intent in my center.
Results: From August 2, 2005 to December 10, 2018, 160 pancreatic resections were done with curative intent in my center. The number of operations per year was 1 in 2005 and gradually increased to 21 in 2018. Thirty-day mortality was 0, and 90-day mortality was 1 (0.6%). Morbidity was found in 65 cases (40.6%). The median follow-up period was 23.2 months and 5-year survival rates were 28.5% for pancreas head cancer, 48.2% for distal CBD cancer, and 72.6% for AOV cancer. I divided patients into 2 groups by the number of annual operations, which is more than 21 per 2 years. The 2 groups showed no differences in terms of morbidity and mortality.
Conclusion: A well-trained low-volume surgeon may perform PD safely at a well-equipped low-volume center.
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KEYWORD
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Outcome, Pancreaticoduodenectomy, Periampullary cancer, Volume
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