Early reoperation following pancreaticoduodenectomy: Impact on morbidity, mortality, and long-term survival

Yonatan Lessing, Niv Pencovich, Nadav Nevo, Nir Lubezky, Yaacov Goykhman, Richard Nakache, Guy Lahat, Joseph M. Klausner, Ido Nachmany

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Reoperation following PD is a surrogate marker for a complex post-operative course and may lead to devastating consequences. We evaluate the indications for early reoperation following PD and analyze its effect on short- and long-term outcome. Methods: Four hundred and thirty-three patients that underwent PD between August 2006 and June 2016 were retrospectively analyzed. Results: Forty-eight patients (11%; ROp group) underwent 60 reoperations within 60 days from PD. Forty-two patients underwent 1 reoperation, and 6 had up to 6 reoperations. The average time to first reoperation was 10.1 ± 13.4 days. The most common indications were anastomotic leaks (22 operations in 18 patients; 37.5% of ROp), followed by post-pancreatectomy hemorrhage (PPH) (14 reoperations in 12 patients; 25%), and wound complications in 10 (20.8%). Patients with cholangiocarcinoma had the highest reoperation rate (25%) followed by ductal adenocarcinoma (12.3%). Reoperation was associated with increased length of hospital stay and a high post-operative mortality of 18.7%, compared to 2.6% for the non-reoperated group. For those who survived the post-operative period, the overall and disease-free survival were not affected by reoperation. Conclusions: Early reoperations following PD carries a dramatically increased mortality rate, but has no impact on long-term survival.

Original languageEnglish
Article number26
JournalWorld Journal of Surgical Oncology
Volume17
Issue number1
DOIs
StatePublished - 31 Jan 2019

Keywords

  • Complication
  • Pancreas
  • Surgery
  • Whipple

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