Pancreatic Cancer Clinical Trial
Official title:
Surgical Intervention After Pancreaticoduodenectomy: Incidence, Indications, Risk Factors and Outcome
The aim of this study is to outline the incidence of early and late reoperation after PD, examine the risk factors for early surgical intervention and its impact on the surgical outcome, hospital stay, diseases recurrence and patient survival, address variable indications for late readmission and reoperation after PD and its impact on patient survival and disease recurrence.
This is a retrospective cohort study of all patients who underwent PD for periampullary
tumors in Gastrointestinal Surgical Center (GISC), Mansoura University, Egypt in the period
between 2000 and 2018.The exclusion criteria included any patients with locally advanced
periampullary tumor, metastases, patients with advanced liver cirrhosis (Child B or C),
malnutrition, or coagulopathy.
Patient data were recorded in a prospectively maintained database. Preoperative variables
included; age, sex, body mass index, patients' symptoms and signs, laboratory tests, tumor
markers and preoperative biliary drainage. Intraoperative variables included; liver status,
tumor size, pancreatic duct diameter, texture of the pancreas, operative time, blood loss,
pancreatic reconstruction method and blood transfusion. Postoperative variables included
postoperative complications, drain amylase, liver function, day to resume oral feeding,
postoperative stay, re-exploration, hospital mortality, postoperative pathology, and surgical
safety margins.
Data regarding reoperation included incidence, male to female ratio, hospital stay, interval
to reoperation, number of explorations, indication of reoperation and surgical management,
and postoperative outcome in terms of morbidity and hospital stay. Follow-up was carried out
one week postoperatively, 3 months, 6 months and then after one year. The minimum duration of
follow up was 2 years. Follow up was done by thorough history taking, clinical examination
and abdominal CT in case of suspicious lesions on pelvi-abdominal ultrasound.
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