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Annals of Oncology 10:S257-S260, 1999
© 1999 European Society for Medical Oncology

Complications after resection of biliopancreatic cancer

Dirk J. Gouma, Thomas M. van Gulik, Laurens T. de Wit and Huug Obertop

Academic Medical Center Amsterdam, The Netherlands

Correspondence to: Prof.Dr.D.J. Gouma, Academic Medical Center, Dept. of Surgery / G4-115, Meibergdreef 9, 1105 AZ AMSTERDAM, The Netherlands

During the past decade the mortality after pancreatico-duodenectomy decreased to 0–4% in centers with experience. The morbidity however remains high although a decrease has also been demonstrated. Leakage of the pancreatic anastomosis is the most severe complication associated with a high mortality reported between 8–40%. Resection of the pancreatic remnant is the most radical treatment but unfortunately associated with insulin dependent diabetes. Subtotal resection of the pancreas tail seems an alternative. The incidence of postoperative bleeding is decreasing in particular bleeding from ulcers. Bleeding from a pseudoaneurysm (2%) is leading to a high mortality up to 50% and early aggressive intervention is mandatory. Delayed gastric emptying is reported between 20–30%, the pathofysiology is still unknown but postoperative intra-abdominal complications proved to be a risk factor. It is now evident that mortality is strongly related with hospital experience and regionalization reduced overall mortality. These findings are arguments to favour centralization of surgery for biliopancreatic cancer.

delayed gastric emptying, leakage, pancreatic resection, mortality, postoperative bleeding, surgical complications


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