Long term outcomes after pancreaticodoudenectomy: a single center experience from Pakistan

Objective: Pancreaticodoudenectomy (PD) remains a challenging surgical procedure. PD outcomes remain under reported from Pakistan. The objective of the current study was to report PD outcomes from a large single center patient cohort. Methods: A total of 155 patients who underwent PD between 2011 and 2019 were included. Outcome was assessed based on morbidity, in hospital mortality and survival. Results: Mean age was 56.8 ±13.5 years (range=8-85). Male to female ratio was (103/52)1.9:1. Overall morbidity was 84/155 (54.2%). Grade B and C pancreatic fistula (PF) were seen in 5 (3.2%) and 6 (3.8%) patients. In hospital mortality was 5/155 (3.2%). The estimated 5 year overall survival (OS) was 11% and 23% for pancreatic and non-pancreatic cancers (P=0.2). The estimated 3 year OS was lower with multivisceral resection (23% vs 5%, P <0.001), advanced tumors (40% vs 11%)(P=0.008) , nodal involvement (34% vs 12%)(P=0.04) and positive microscopic margins (30% vs 8%, P=0.006). Conclusion: Short and long term outcomes comparable to international high volume centers for PD can be achieved with site specific focus in hepatopancreatobiliary surgery. Continuous...