Perioperative and long-term outcomes of pancreaticoduodenectomy in patients undergoing hemodialysis: a case series of eight patients

This report retrospectively evaluated the perioperative and long-term outcomes of eight cases of pancreaticoduodenectomy (PD) in patients undergoing hemodialysis. The median age and duration of hemodialysis of the patients were 68 and 6 years, respectively. The Preoperative Charlson Comorbidity Index and abdominal aortic calcification scores were generally high. The median operative time and blood loss volume were 454 min and 673 ml, respectively. The 30- and 90-day mortality rates were 0%; however, Clavien-Dindo grade ≥IIIa postoperative complications occurred in four cases, with one in-hospital death due to superior mesenteric artery thrombosis 6 months postoperatively. Six of the eight patients died within 8 years due to causes other than cancer recurrence. Although PD is technically feasible for patients undergoing hemodialysis, it is associated with significant perioperative and long-term risks. Therefore, careful patient selection through preoperative counseling and multidisciplinary management is essential to achieve the best possible outcomes.