100 AND 45 CONSECUTIVE PANCREATICODUODENECTOMIES WITHOUT MORTALITY

Objective A review of mortality and morbidity for pancreaticoduodenect omy was performed for 145 consecutive patients who underwent the opera tive procedure between 1988 and 1991. Summary Background Data In the p ast, pancreaticoduodenectomy has carried a high hospital morbidity and mortality. During the 1970s, many considered that the operation shoul d be abandoned. Recent data, however, suggest that a marked drop in bo th morbidity and mortality have occurred for this operative procedure. Methods Among the 145 consecutive patients who underwent pancreaticodu odenectomy, 108 patients were 69 years of age or younger, and 37 were 70 years of age or older. Four patients were 80 years of age or older. One hundred and seven patients had a malignant neoplasm, whereas 38 p atients had benign disease. There were no significant differences in p reoperative risk factors when the younger and older, and benign diseas e and malignant disease groups were compared. Results Mean operative t ime was 7.3 hours. Median blood loss was 0, indicating that more than one-half of the patients underwent pancreaticoduodenectomies without b lood transfusions. There were no significant differences in postoperat ive complications when the younger and older, and benign disease and m alignant disease groups were compared. There was no hospital or 30-day mortality. Conclusions With appropriate preoperative selection, virtu ally any patient in any age group, with benign or malignant disease, c an undergo pancreaticoduodenectomy with minimal risk of hospital morta lity.