Objective: To analyze data in a single institution series of pancreaticoduodenectomies (PD) performed in a 7-year period after the transition to a high-volume center for pancreatic surgery.
Background: PD has developed dramatically in the last century. Mortality is minimal yet complications are still frequent (around 40%). There are very few reports of PD in Latin America.
Methods: Data on all PDs performed by a single surgeon from March 2000 to July 2006 in our institution were collected prospectively.
Results: During the study's time frame 122 PDs were performed; 84% were classical resections. Mean age was 57.9 years. Of the patients, 51% were female. Intraoperative mean values included blood loss 881 ml, operative time 5 h and 35 min, and vein resection in 14 cases. Both ampullary and pancreatic cancer accounted for 34% of cases (42 patients each), 5.7% were distal bile duct and 4% duodenal carcinomas. Benign pathology included chronic pancreatitis, neuroendocrine tumors, cystic lesions, and other miscellaneous tumors. Overall operative mortality was 6.5% in the 7-year period, 2.2% in the later 5 years. There was a total of 75 consecutive PDs without mortality. Of the patients, 41.8% had one or more complications. Mean survival for pancreatic cancer was 22.6 months and ampullary adenocarcinoma was 31.4 months.
Conclusion: To our knowledge, this is the largest single surgeon series of PD performed in Latin America. It emphasizes the importance of experience and expertise at high-volume centers in developing countries.