Readmission Common After Pancreatoduodenectomy
NEW YORK (Reuters Health) Dec 10 -
It seems that resection of periampullary malignancy that is intended to be curative is associated with a high rate of readmission and limited survival.
In a review of 283 consecutive patients who underwent pancreatoduodenectomy, 106 had to be readmitted to the hospital, Dr. R. C. I. van Geenen and colleagues from the Academic Medical Center in Amsterdam report in the November issue of the British Journal of Surgery.
"Although mortality and morbidity rates after pancreatoduodenectomy have reached acceptable levels, a rather high percentage of patients (38%) needs to be readmitted in the months after resection," they write. Of the 283 resections, 243 were for malignant disease and 40 for benign disease.
Sixty percent of readmissions were due to tumor recurrence and 44% were due to surgery-related complications such as abscess, fistula and gastrointestinal obstruction. Three of the 283 patients died in the hospital, for an in-hospital mortality rate of 1%.
According to Dr. van Geenen and colleagues, readmission due to surgical complications was associated with a "good prognosis," but survival after surgical bypass for tumor recurrence was "limited," especially when ascites was present.
"Ascites is a significant predictor of poor survival and therefore should be considered a contraindication to surgery," the team writes.
Brit J Surg 2001;88:1467-1471.
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