Abdullah GÜNEŞ, Erdem OKAY, Çağrı TİRYAKİ, Ertuğrul KARĞI, Burcu ERBAY

Outcomes of Pancreaticoduodenectomy Surgeries: A Single Center Experience With 71 Cases

Amaç: Kliniğimizde gerçekleştirilen pankreatikoduodenektomi operasyonu sonuçlarının morbidite ve mortalite hızları ve güvenilirlik açısından retrospektif olarak değerlendirilmesi. Gereç ve Yöntemler: Ocak 2007-Eylül 2012 tarihleri arasında Kocaeli Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda Whipple operasyonu yapılan 71 hastanın dosya kayıtları morbidite, mortalite ve güvenilirlik açısından geriye dönük olarak incelenmiştir. Yaş, cinsiyet, lezyon tipi ve lokalizasyonu, cerrahi özellikler ve postoperatif komplikasyonlar kaydedildi. Bulgular: Ortalama yaşı 59.9 yıl olan ve pankreatikoduodenektomi uygulanan 71 hasta (48 erkek, 23 kadın) çalışmaya dahil edildi. Kırkiki olgu (%59) pankreas başı, 19 olgu (%27) ampulla, 4 olgu (%5,5) duodenum, 4 olgu (%5,5) koledok malignitesine sahip idi. İki olguya ise (%3) pankreatit nedeniyle cerrahi uygulandı. Cerrahiye bağlı mortalite oranı %2,8 (2 olgu) idi. En sık rastlanan postoperatif komplikasyonlar; mide boşalımında gecikme (%19), pankreas fistülü (%14) ve yara enfeksiyonu (%10) idi. Postoperatif morbidite oranı ise %28 olarak saptandı. Sonuç: Pankreas ve diğer periampuller bölge tümörleri ciddi morbiditeye neden olan klinik problemlerdir. Geleneksel olarak bu hastalar karanlık bir prognoza sahip olmakla birlikte, doğru evreleme ve uygun hasta seçimi daha iyi sonuçlar elde edilmesini sağlar. Tek uzun süreli hayatta kalım sebebi olması nedeniyle, mümkün olan her durumda cerrahi rezeksiyon denenmelidir. Sonuç olarak, bu küçük olgu serisinde pankreotikoduodenektomi cerrahisi pankreas ve koledok patolojilerinin tedavisinde etkin ve güvenilir bir cerrahi yöntem olarak bulunmuştur. Cerrahi deneyimi olan düşük yoğunluklu merkezlerde de düşük mortalite ve morbidite oranları ile bu cerrahi işlem yapılabilmektedir

Pankreatikoduodenektomi Operasyonu Sonuçları: 71 Olguluk Tek Merkez Deneyimi

Aim: To retrospectively evaluate the results our pancreaticoduodenectomy surgeries in terms of morbidity and mortality rates as well as safety. Materials and methods: Medical records of 71 patients, who underwent pancreaticoduodenectomy surgery between January 2007 and September 2012 at Department of General Surgery, Kocaeli University School of Medicine, were examined retrospectively. Age, sex, the type and localization of the lesion, surgical properties and postoperative complications were studied. Results: A total of 71 patients (48 male, 23 female) with a mean age of 59.9 years who underwent pancreaticoduodenectomy were included in the study. Forty two patients (59%) had pancreatic head malignancies, 19 patients (27%) had ampulla malignancies, 4 patients (5.5%) had duodenum malignancies and 4 patients (5.5%) had common bile duct malignancies. Two of our cases (3%) underwent surgery for pancreatitis. Surgery related mortality rate was 2.8% (2 cases). The most frequently encountered complications were delay in gastric emptying (19%), pancreatic fistula (14%) and wound infection (10%). Postoperative morbidity rate was detected to be 28%. Conclusion: Pancreatic and other periampullary tumors are serious clinical problems that cause morbidity. Traditionally, these patients have a dark prognosis but correct staging and appropriate patient selection allow better results. Surgical resection, the one reason for long-term survival, should be preferred whenever possible. In conclusion, we have found out that pancreaticoduodenectomy surgery is an effective and safe surgical method in the treatment of pancreas and common bile duct problems. This surgical procedure can be performed with low morbidity and mortality rates in experienced but low-density centers

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