Prognostic factors for survival and surgical complications in Whipple's pancreatoduodenectomy during a 10-year experience.

Background: Periampullary neoplasms account for over 30,000 cancer-related deaths per year in the United States. Pancreaticoduodenectomy (PD) is considered the surgical standard and is the only curative treatment option for these pathologies.

Objective: The objective of this study was to report the prognostic factors in survival and surgical complications in PD.

Materials And Methods: A total of 178 cases are reported, several variables were reviewed and the same surgical technique was used by the same surgeon.

Results: A total of 151 PD were reviewed. The most common initial symptoms were jaundice, 111 (73%), abdominal pain, 20 (13%), and oral intolerance, 10 (6%). Poor prognostic factors for survival were the presence of a previous pathology, days of hospitalization, positive margins, and weight loss.

Discussion: With the experience gained, a decrease in surgical time, intraoperative bleeding, and transfusions performed was achieved. Our complication rate remained at 20%, lower than that reported in literature.

Conclusion: PD is the only option of cure for patients with pancreatic and periampullary tumors. This procedure has been linked to high morbidity and mortality even in high-volume centers. A pancreatic fistula is the most feared complication; therefore, multiple pancreatojejunostomy techniques have been described in literature. It is important to continue reporting these cases to reach a consensus on this technique.