Insights from 151 Consecutive Pancreaticoduodenectomies at a High-Volume Tertiary Center: A Cross-Sectional Observational Study

Aim: Pancreaticoduodenectomy (PD) is a complex and essential procedure in the treatment of localized periampullary neoplasms.Due to its comlexity, postoperative morbidity and mortality remain significant concerns.The aim of this study was to evaluate our short-term outcomes, categorize them according to international standards, and compare our findings with those reported in the existing literature. Materials and Methods:One hundred and fifty-one patients underwent classical PD for pancreatic tumors between February 2019 and May 2023 at the Department of General Surgery, Marmara University Faculty of Medicine, Department of General Surgery.Patients meeting the inclusion criteria were enrolled in the study.Clinical, operative, pathological, and short-term outcome data, prospectively recorded, were retrospectively analyzed. Results:The mean age of the patients was 63.6 years, with 87 (57.6%) being male.The median operative time was 227.448.5 minutes.Clavien-Dindo grade 3 or higher complications were observed in 38 patients (25.2%).Intraabdominal abscesses were noted in 9 patients, chylous fistula in 9 patients, and postoperative bleeding in 6 patients.Postoperative pancreatic fistula was diagnosed in 54 patients (35.8%), of which 38 (70.3%) were classified as grade A and 16 (29.7%)as grade B. No grade C pancreatic fistulas were observed.The overall incidence of delayed gastric emptying was 26.5% (n=40).Two patients required reoperation: one for postoperative bleeding and the other for gastroenterostomy leakage.In the early postoperative period, five patients died. Conclusion:Effective management of complications following complex surgeries plays a critical role in improving postoperative outcomes.The morbidity and mortality rates in our series were relatively lower compared to those reported in the literature.