The aim of this paper is to reevaluate the factors responsible for hospital morbidity, mortality and post-operative survival following pancreaticoduodenectomy for ampullary cancer.
Peri-operative data on 132 patients undergoing pancreaticoduodenectomy for ampullary cancer were correlated with post-operative morbidity, mortality and long-term survival.
Three factors were found to correlate well with post-operative morbidity ; however, only intraabdominal or wound sepsis was an independently significant variable.
Four parameters correlated well with hospital mortality, while multivariate analysis revealed age>75y/o, positive blood culture and albumin <= 3.0g% to be independently significant in predicting post-operative mortality.
Univariate analysis identified seven significant factors : 1) age <= 75y/o, 2) hematocrit>30%, 3) blood urea nitrogen<20mg%, 4) earlier TNM staging, 5) smaller tumor size, 6) negative nodal status and 7) well-differentiated tumors, which were associated with longer survival.
However, multivariate analysis disclosed nodal status and hematocrit to be the two most significant independent variables.
Although radical resection for ampullary cancer can be performed with a low mortality in recent years, the justification for performing this major operation in a patient over 75 years of age should be reevaluated for prohibitively high mortality (10x) and shorter survival (median 6.0 months). (...)
Mots-clés Pascal : Carcinome, Ampoule Vater, Facteur risque, Duodénopancréatectomie, Postopératoire, Morbidité, Mortalité, Survie, Etiologie, Evaluation, Homme, Duodénum, Pancréas, Tumeur maligne, Appareil digestif pathologie, Pancréas pathologie, Chirurgie, Statistique, Réévaluation
Mots-clés Pascal anglais : Carcinoma, Vater ampulla, Risk factor, Pancreatoduodenectomy, Postoperative, Morbidity, Mortality, Survival, Etiology, Evaluation, Human, Duodenum, Pancreas, Malignant tumor, Digestive diseases, Pancreatic disease, Surgery, Statistics
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0444270
Code Inist : 002B25G03. Création : 22/03/2000.