Readmissions after pancreatoduodenectomy

Background: Readmission after pancreatoduodenectomy because of tumour recur rence or surgery-related complications can adversely affect patient outcome . Methods: From October 1992 to June 1999, 283 consecutive resections were pe rformed (243 for malignant disease and 40 for benign disease). The hospital mortality rate was 1 per cent (three of 283). All readmissions were analys ed with regard to indication, treatment and outcome. Results: One hundred and six patients (38 per cent) were readmitted, 64 (60 per cent) because of tumour recurrence and indications such as gastrointes tinal obstruction (n=19), biliary obstruction (n=15) and pain (n=21), of wh om 30 patients (47 per cent) were in a preterminal condition. Median hospit al stay and hospital-free survival after discharge were 14 and 51 days resp ectively. Median survival after surgical treatment (n=14) was 58 days, and ascites was significantly associated with poor survival. Forty-seven (44 pe r cent) of the patients were readmitted for surgical complications such as abscess (n=11), fistula (n=8) and gastrointestinal obstruction (n=8). Media n hospital stay was 15 days and median hospital-free survival after dischar ge was 1035 days. Conclusion: Readmission after pancreatoduodenectomy was common (38 per cent ), 60 per cent for tumour recurrence and 44 per cent for surgery-related co mplications. Survival after surgical bypass procedures for tumour recurrenc e was limited, particularly when ascites was present. Patients readmitted f or complications of surgery had a good prognosis.