COMPLICATIONS REQUIRING REOPERATION FOLLOWING PANCREATECTOMY

Conclusions. In this series, the overall reoperative rate following pa ncreatic surgery is 9%, Complications following pancreatectomy that re quire reoperation fall into four categories: hemorrhage, infectious, d elayed gastric emptying, and anastomotic leak. A delay in the manageme nt of these types of complications can be fatal. Background. Despite t he improvement in the morbidity and mortality rates associated with pa ncreatic resection, complications still arise that require surgical in tervention. This study reviews the pancreatic surgical experience at a major medical center to determine the overall reoperative complicatio n rate. Study Design. From 1985 to 1995, 107 patients underwent pancre atic resection. There were 50 pancreaticoduodenectomies, 20 total panc reatectomies, and 37 distal pancreatectomies for 102 periampullary or pancreatic cancers and five for chronic pancreatitis. The operative mo rtality rate was 6.5% and the morbidity rate was 43%. Ten patients (9% ) developed complications that required reoperation. Results. Re-explo ration was performed in five patients for hemorrhage. Four patients ha d bleeding intraabdominally and one had a suture line bleed. One patie nt developed a wound infection and fascial necrosis which necessitated reoperation. Three patients were explored for sepsis and one was foun d to have a pancreatic leak. One patient had persistent gastric outlet obstruction and he required conversion of the gastrojejunostomy to a Roux-en-y anastomosis. The mortality rate for re-exploration was 3/10 (30%).