Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

IntroductionPancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40-50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. MethodsA total of 596 patients that underwent PD for PDA between 2001 and 2009 were identified from a prospective database. Complications were defined and graded (1-5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as grade 3. Postoperative mortality (90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. ResultsMedian survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n=129). Our 90 day mortality was 3.7% (n=22). Anastomotic fistula/leak/abscess rate was 14% (n=82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) >600ml, length of stay (LOS) >10 days, margin positivity, and vascular procedures as predictors of decreased overall survival (P<0.05). High grade complications were not associated with overall survival (P=0.948). ConclusionIn this study, the occurrence of high grade postoperative complications was not associated with overall survival. J. Surg. Oncol. 2016;113:188-193. (c) 2015 Wiley Periodicals, Inc.