Immediate results of surgical treatment of patients with malignant tumors of the biliopancreatoduodenal region

Objective: Pancreatoduodenectomy (PD) is considered one of the most technically demanding procedures in abdominal surgery. This operation is associated with a high risk of postoperative complications, ranging from 30% to 60%. One of the most common complications is delayed gastric emptying (DGE). Although DGE is not a life-threatening complication, it causes significant patient discomfort, prolongs hospital stay, increases treatment costs, leads to repeated hospitalizations, and delays the initiation of adjuvant chemotherapy. Our aim was to evaluate the outcomes of surgical treatment of patients with malignant tumors of the biliopancreatoduodenal region in Kyrgyzstan at a single center. Methods: This was a retrospective study. The study was conducted at the I.K. Akhunbaev Clinic of the National Hospital under the Ministry of Health of the Kyrgyz Republic, Bishkek. Between 2009 and 2024, a total of 90 PDs were performed for malignant neoplasms of the biliopancreatoduodenal region. The study cohort consisted of 70 men and 20 women, with a mean age of 57.5 (1.4) years. We assessed patients` outcomes as postoperative complications and mortality after surgery. Results: Postoperative complications occurred in 26 patients (28.8%). The most severe complications included pancreaticogastrostomy leakage with pancreatic fistula formation in 6 patients (6.7%), biliodigestive anastomosis leakage in 1 patient (1.1%), delayed gastric emptying in 20 patients (22.2%), gastroenteroanastomosis leakage in 3 patients (3.3%), and pulmonary embolism in 1 patient (1.1%). Reoperation was required in three cases. Postoperative mortality was 3.6%. Conclusion: At present, pancreatoduodenectomy remains the only radical treatment for tumors of the biliopancreatoduodenal region. Postoperative complications were observed in 28.8% of patients. In 85.72% of cases, complications were managed conservatively with favorable outcomes.