Azhar Shabbir, James Schneider, Momin Malik, Bassam Alkari, Irfan Ahmed.
Early VS Elective Pancreaticoduodenctomy In The Management Of Pancreatic Cancer.
Isra Med J Jan ;8(2):103-6.

OBJECTIVE: To compare morbidity and mortality of pancreatico-duodenectomy in patients undergoing early surgery versus on the routine elective waiting lists. STUDY DESIGN: Retrospective interventional study. PLACE AND DURATION: The study was conducted inDepartment of Hepato-pancreatico-biliary Surgery, Aberdeen Royal Infirmary, UK st st from 1 June 2009 to 31 December 2011. METHODOLOGY: All patients who underwent a pancreatic oduodenectomy were included. Data was collected to identify patients who had undergone pancreatic oduodenectomy within 14 days of decision to operate and those afterwards. Further data collected included age at surgery, pathology and node involvement, serum bilirubin prior to surgery, peri-operative blood loss, duration of surgery, post-operative re-operations, drainage of collections and minor procedures, recurrence rate within 1 year and 18 month and % survival with after 18 months of the surgery for patients with malignant disease. RESULTS: The emergency population comprised of 47% patients and the elective population included 53% patients. The average ages at surgery were 65.0 years versus 70.0 years old respectively. There were 3 re-operations in the emergency population and 2 reoperations in the elective population. 50.0% patients in the emergency population were lymph node positive (N1-N3) versus 58.8% elective patients. 8 patients in the emergency population and 10 elective pancreatic cancer patients had confirmed recurrence. The average number of days between diagnosis and death for the emergency group was 354 days versus 398 days for the elective population. The mortality rate within 18 months was 29.4% within 18 months for emergency group, compared to 57.9% for the elective population. CONCLUSIONS: Expeditious pancreatico-duodenectomy is associated with greater immediate post-operative morbidity and increased rate of reoperation but overall survival in 18 months have been noted to be better but not statistically different as compared to routine elective pancreaticoduodenectomy. However considering this a relatively small sample size, further studies with larger numbers is needed to confirm this finding.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com