A case series of emergency pancreaticoduodenectomies: What were their indications and outcomes?

Kit-Fai Lee; Janet Wui Cheung Kung; Andrew Kai Yip Fung; Hon-Ting Lok; Charing Ching Ning Chong; John Wong; Kelvin Kai Chai Ng; Paul Bo San Lai

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저자정보: Kit-Fai Lee (The Chinese University of Hong Kong) Janet Wui Cheung Kung (The Chinese University of Hong Kong) Andrew Kai Yip Fung (The Chinese University of Hong Kong) Hon-Ting Lok (The Chinese University of Hong Kong) Charing Ching Ning Chong (The Chinese University of Hong Kong) John Wong (The Chinese University of Hong Kong) Kelvin Kai Chai Ng (The Chinese University of Hong Kong) Paul Bo San Lai (The Chinese University of Hong Kong)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제27권 제4호

발행연도: 2023.11

수록면: 437 - 442 (6page)

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Emergency pancreaticoduodenectomy (EPD) is a rarely performed operation. It is important to know the indications and outcomes of EPD to have a better understanding of its application in clinical practice. A review of eight consecutive cases of EPD was done. Between January 2003 and December 2021, 8 out of 370 patients (2.2%) in a single center received pancreaticoduodenectomy as emergency. There were six males and two females with a median age of 45.5 years. The indications were trauma in three patients, bleeding tumors in two patients, and one patient each in obstructing duodenal tumor, postoperative complication and post-endoscopic retrograde cholangiopancreatography (ERCP) complication. The median operative time and blood loss were 427.5 minutes and 1,825 mL, respectively. There was no operative mortality. Seven patients (87.5%) had postoperative complications. Three patients (37.5%) developed postoperative grade B pancreatic fistula. The median postoperative hospital stay was 23.5 days. Five patients were still alive while three patients survived for 13, 31, and 42 months after the operation. The causes of death were recurrent tumors in two patients, and sepsis in one patient. According to this case series, EPD is associated with increased morbidity and pancreatic fistula, but is still deserved in life-threatening situations and long-term survival is possible after EPD.

#Pancreaticoduodenectomy #Whipple operation #Emergency operation #Pancreatic trauma

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