Nederlands tijdschrift voor geneeskunde · 1997
[Complications, hospital mortality and survival following partial pancreaticoduodenectomy].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gouma D J, de Wit L T, van Berge Henegouwen M I, Allema J H, van Gulik T H, Obertop H
Аннотация
OBJECTIVE: To analyse hospital mortality, complications and survival of patients after subtotal pancreaticoduodenectomy in the Academic Medical Centre, Amsterdam, the Netherlands, 1983-1996.
DESIGN: Partly retrospective (1983-August 1987), partly prospective (September 1987-1996).
METHOD: Patient characteristics, indication for surgery, postoperative complications, mortality and survival of patients who underwent subtotal pancreaticoduodenectomy were recorded in a computer database. Patients were subdivided into three groups (1983-September 1992; October 1992-1994; 1995-September 1996) to analyse the influence of change in surgical technique and the increase of experience.
RESULTS: From 1983-to September 1996, 312 consecutive patients underwent a subtotal pancreaticoduodenectomy. Hospital mortality decreased from 4.9% to 1.4% in the last period (1995-1996). The complication rate decreased from 60% to 41%. The hospital stay decreased from median 24 days to 16 days. The actualized 5-year survival analysed for patients operated from 1983-to September 1992 was 31%. Patients with ampullary tumours had a 5-year survival of 50%. The 5-year survival of patients with bile duct and pancreatic carcinoma was 24% and 15% respectively.
CONCLUSIONS: Subtotal pancreaticoduodenectomy can be performed safely with a low mortality (< 2%) in specialised centres. The morbidity is still substantial (40%). The survival is mainly dependent on type of tumour and patient selection and is approximately 50% for patients with ampullary tumours. The pylorus preserving procedure has become the standard operation.
DESIGN: Partly retrospective (1983-August 1987), partly prospective (September 1987-1996).
METHOD: Patient characteristics, indication for surgery, postoperative complications, mortality and survival of patients who underwent subtotal pancreaticoduodenectomy were recorded in a computer database. Patients were subdivided into three groups (1983-September 1992; October 1992-1994; 1995-September 1996) to analyse the influence of change in surgical technique and the increase of experience.
RESULTS: From 1983-to September 1996, 312 consecutive patients underwent a subtotal pancreaticoduodenectomy. Hospital mortality decreased from 4.9% to 1.4% in the last period (1995-1996). The complication rate decreased from 60% to 41%. The hospital stay decreased from median 24 days to 16 days. The actualized 5-year survival analysed for patients operated from 1983-to September 1992 was 31%. Patients with ampullary tumours had a 5-year survival of 50%. The 5-year survival of patients with bile duct and pancreatic carcinoma was 24% and 15% respectively.
CONCLUSIONS: Subtotal pancreaticoduodenectomy can be performed safely with a low mortality (< 2%) in specialised centres. The morbidity is still substantial (40%). The survival is mainly dependent on type of tumour and patient selection and is approximately 50% for patients with ampullary tumours. The pylorus preserving procedure has become the standard operation.