Abstract

Purujit Choudhury* and Dr. Ashinta Pegu

ABSTRACT

Background: Improvements in the outcome of distal pancreatectomy (DP) for cancer is well accepted, but the series were small and heterogeneous. The aim of the present study was to assess perioperative and long-term outcomes of DP for pancreatic adenocarcinoma in the era of multimodal treatment of pancreatic cancer. Materials and Methods: This was a hospital-based study of all patients undergoing DP for pancreatic adenocarcinoma between 2013 and 2020 in different unit of Gauhati Medical College. Postoperative and long-term outcomes were assessed retrospectively, and outcome predictors were explored by multivariable analysis. Results: A total of 278 patients were enrolled. Multivisceral resections were performed in 58 patients (20 percent), venous resections in 33 (11 percent) and arterial resections in 11 (4 percent). Neoadjuvant chemoradiotherapy was used in 20 patients. Postoperative complications occurred in 96 patients (34 percent) and pancreatic fistulas developed in 76 (27percent). The postoperative 90-day mortality rate was 5 percent. In univariable analysis, multivisceral resection was the only factor associated with postoperative morbidity (p= 0 - 048). Age 65 years or less, body mass index of at least 30 kg/m2 and absence of preoperative chemoradiotherapy were associated with an increased risk of pancreatic fistula in multivariable analysis. Overall, survival rates at 3 and 5 years were 44 and 29 percent respectively. In multivariable analysis, only the presence of lymph node metastases was associated with poorer overall survival. Conclusions: Postoperative morbidity and mortality associated with pancreatic fistula remain considerable after DP, but both short- and longterm survival have improved markedly.