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KMID : 0377220030280010059
Medical Journal of Chosun Univercity
2003 Volume.28 No. 1 p.59 ~ p.65
Risk Factors Influencing the Results after Pancreatoduodenectomy
Jeong Hee-Seok

Jeong Gui-Ae
Jang Jeong-Hwan
Kim Kweon-Cheon
Min Young-Don
Kim Seong-Hwan
Abstract
Background : Pancreatoduodenectomy is a widely used technique in the treatment of periampullary, duodenal and cephalic pancreatic disease. Although many improvements have been made in operative technique and posmiddleerative care, pancreatoduodenectomy remains a technically difficult procedure attended by relatively high morbidity and mortality rates.

Materials and methods : The hospital records of 51 patients who underwent pancreatoduodenectomy at the Chosun University Hospital between 1994 and 2001 were reviewed. Clinical data and the following morbidity and mortality were recorded The risk factors were analyzed by a Chi-square test.

Results : Fifth decade was the most prevalent ages (43.1%) The mean age was 59 years (ranging from 29 to 78) and the male to female ratio was 26 to 1. The periampullary cancer was the most reason to operation (86%) and injury due to trauma, adenocarcinoma of stomach, colon cancer, chronic pancreatitis in order Posmiddleerative complications were developed in seventeen patients and anastomotic leakage was the most common complication Death within a month after operation was 3 (5.8%) and the one of the cause of death was leakage in two patients, the other cause was intraadbominal bleeding in one patients. The cardiovascular disease, pulomnary problem, diabetes, level of bilirubin were checked preoperatively and showed no statistical difference in the posmiddleerative morbidity. The other factors such as amount of bleeding, operation time were not influencing posmiddleerative complications. The occurrence of leakage in eight cases of drainage tuve inserted into the pancreaticojejunostomy site was not different from no tuve insertion statistically

Conclusion: old age of the patients, diabetes mellitus and massive intraoperative hemorrhage are the risk factors influencing the results after pancreatoduodenectomy. Morbidity and mortality after pancreatoduodenctomy can be devreased if a prudent selection of paients is made and the operation is performed by accomplushed surgeon.
KEYWORD
pancreatoduodenectomy, periampullary disease
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