RETROSPECTIVE COORT: EPIDEMIO-ONCO-LOGICAL ANALYSIS OF DUODENOPANCRE-ATECTOMIES AND THEIR OUTCOMES AT SANTA ISABEL HOSPITAL IN 2018-2019

Pancreatic cancer is a disease with high lethality and poor prognosis due in part to being a silent neoplasm until it reaches advanced stages. With the evolution of anesthetic control, perioperative management and operative techniques, duodenopancreatectomy, the only curative technique for periamolar neoplasia, could be performed more safely, with mortality below 2% and morbidity between 10-15% among current epidemiological indices. The incidence of postoperative complications remains high, between 30-61%. The objective of this study is the retrospective analysis of duodenopancreatectomies performed at the services of Hospital Santa Isabel, Blumenau - SC, from February 2018 to May 2019, totaling 18 patients. In addition to direct comparison with international epidemiological data and the profile of the patients studied, we performed a bivariate comparative analysis: between surgical time as an independent risk factor for the development of complications; between the type of surgical reconstruction and the development of complications. The technique chosen for duodenopancreatectomy was performed within the standard practice of Brazil. Portal vein resection was required in one patient due to tumor invasion. The pancreatic anastomosis performed was pancreatojejunal type, after insertion of urethral tube into the pancreatic duct and ductomucous anastomosis. Next, the biliodigestive anastomosis 15cm from the pancreatic anastomosis and gastroenteroanastomosis in the posterior gastric wall was performed with Bilroth II reconstruction in 3 patients and Roux Y in 15 patients. The need for blood transfusion in the peri- and postoperative period was recorded. The operative time was also analyzed. It was also recorded the number of days of hospitalization, besides the amylase of the drain in the 1st and 3rd postoperative days. The histopathological diagnosis was confirmed by the analysis of the fixed surgical specimen. Postoperative death is considered to be death up to 30 days after surgery. Pancreatic duodenopancreatectomy is still associated with high morbidity, but it is still the only solution for peri-ampolar pancreatic neoplasia. With adequate selection of patients undergoing TDP and intensification of postoperative care, this procedure can be performed more safely and with longer survival.

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Artikel online veröffentlicht:
23. Oktober 2019