Open AccessComplications of Pancreatic Cancer Resection
Author(s) -
Christopher Halloran,
Paula Ghaneh,
L. Bosonnet,
Mark Hartley,
Robert Sutton,
John P. Neoptolemos
Publication year - 2002
Publication title -
digestive surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.762
H-Index - 69
eISSN - 1421-9883
pISSN - 0253-4886
DOI - 10.1159/000052029
Subject(s) - medicine , octreotide , pancreatic cancer , pancreatic fistula , mortality rate , surgery , complication , periampullary cancer , incidence (geometry) , cancer , pancreaticoduodenectomy , general surgery , fistula , resection , somatostatin , pancreas , physics , optics
Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20% but is around 6% or less in specialist centres. The overall complication rate even in specialist centres is 18-54%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4% for fistula, 9.9% for delayed gastric emptying, 4.8% for bleeding, 4.8% for wound infection and 3.8% for intra-abdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9% with a mortality rate of 23 to 67%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.