Postoperative outcomes of pancreatoduodenaectomy with colon resection

AIM: to assess early results of pancreatoduodenalectomy with colon resection for cancer.PATIENTS AND METHODS: a retrospective cohort two-center controlled study included 927 patients. The first group included 95 patients after рancreatoduodenalectomy with colon resection. The second group included 832 patients who underwent рancreatoduodenalectomy without resection of adjacent organs. The first group was divided into two subgroups: the first subgroup is patients with malignant neoplasms of the colon — 42, the second subgroup is patients with malignant neoplasms of other sites — 53.RESULTS: the group of patients with рancreatoduodenalectomy and colon resection was significantly more often assessed according to the ECOG 2–3 and ASA 3 (52/95 (54.7%) vs 63/669 (9.4%), p < 0.001 and 25/95 (26.3%) vs 104/669 (15.5%), respectively). The postoperative morbidity rate, as well as their class according to Clavien-Dindo, was homogeneous in both groups. The postoperative mortality rate was higher in the group of рancreatoduodenalectomy with colon resection (13/42 (31.0%) vs 49/832 (5.9%), p = 0.004). When comparing with subgroups, the postoperative mortality rate was comparable between patients after рancreatoduodenalectomy with colon resection for colon cancer and рancreatoduodenalectomy without resection of adjacent organs (3/42 (7.1%) vs 49 / 832 (5.9%), р = 0.7), and was significantly higher in the рancreatoduodenalectomy with colon resection (10/53 (18.9%) vs 49/832 (5,9%), р < 0.001).CONCLUSION: patients in the рancreatoduodenalectomy with colon resection group are clinically more severe, and the operation itself is accompanied by a high rate of postoperative morbidity, but a comparable with рancreatoduodenalectomy in a standard volume, without resection of adjacent organs. Рancreatoduodenalectomy with colon resection for colon cancer is also associated with a comparable rate of postoperative mortality with standard рancreatoduodenalectomy, while рancreatoduodenalectomy with colon resection for cancer of other locations is characterized by a significantly higher level of postoperative mortality.