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Risks of Perioperative Mortality with Pancreaticoduodenectomy

  • Chapter
Pancreatic Cancer

Part of the book series: M. D. Anderson Solid Tumor Oncology Series ((MDA))

Summary

Over the past decade, pancreaticoduodenectomy has become a much safer operation, with mortality risks at many centers considerably below 5%. Clinical decision making should account for patient characteristics that increase these risks. Although information about patient-level risk factors is currently imperfect given the lack of large population-based studies based on clinical data, factors that may increase mortality risks include advanced age, diminished functional status, hypoalbuminemia, and hyperbilirubinemia. Currently, there is little evidence that surgical mortality is influenced by treatment-related variables, including preoperative biliary drainage, neoadjuvant chemoradiation, perioperative administration of octreotide, or the extent of surgical resection. However, mortality risks with pancreaticoduodenectomy are heavily influenced by where surgery is performed. Given considerably lower mortality rates observed at high-volume centers for pancreatic surgery, patients being evaluated in other settings should be given the option of referral.

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Authors
  1. Laura A. Lambert
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  2. John D. Birkmeyer
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Editors and Affiliations

  1. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Douglas B. Evans M.D. (Professor of Surgery) & Peter W. T. Pisters M.D., F.A.C.S. (Associate Professor of Surgery) (Professor of Surgery) &  (Associate Professor of Surgery)

  2. Department of Gastrointestinal Medical Oncology, The University Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    James L. Abbruzzese M.D. (Professor of Medical Oncology, Chairman) (Professor of Medical Oncology, Chairman)

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Lambert, L.A., Birkmeyer, J.D. (2002). Risks of Perioperative Mortality with Pancreaticoduodenectomy. In: Evans, D.B., Pisters, P.W.T., Abbruzzese, J.L. (eds) Pancreatic Cancer. M. D. Anderson Solid Tumor Oncology Series. Springer, New York, NY. https://doi.org/10.1007/0-387-21600-6_17

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