23 Pancreatoduodenectomy for Malignancy: Which Patients Are High-Risk?

Abstract Aim In the absence of metastases, pancreatoduodenectomy (PD) is indicated in fit patients with a resectable pancreatic head/periampullary cancer. Surgeons should have sound understanding its complication profile for consenting purposes and to benchmark their rates. This study aimed calculate overall incidence PD complications identify risk factors. Method A multicentre retrospective cohort confirmed malignancy was conducted (29 centres from 8 countries). The severity all recorded calculated. Patients who experienced any complication, major morbidity, clinically relevant postoperative fistula (CR-POPF), post-pancreatectomy haemorrhage (PPH) 90-day mortality were compared those did not experience these outcomes. Results 1348 included patients, morbidity 53% 4%, respectively. total, 1340 recorded; 72%, 18%, 6% 4% Clavien-Dindo (CD) grades I-II, III, IV V, CR-POPF, PPH, chyle leak, bile leak gastro-jejunal affected 8%, 6%, 3% 2% Following multivariable analysis, high body mass index (BMI, p = 0.007), American Society Anesthesiologists (ASA) grade >II (p<0.0001) pylorus-resecting approach (p 0.005) correlated morbidity. addition, ASA at increased raised BMI CR-POPF 0.001). Conclusions our study, over 50% However, most CD I-II. High BMI, associated studied adverse