Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report
Background: There were only few publications related to pancreaticoduodenal resection (PDR) /Whipple procedure in Indonesia in the past decade. Method: Retrospectively report of the characteristics and outcomes of PDR performed by Cipto Mangunkusumo Hospital surgical team from 1993 to 2017 were c...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Interna Publishing
2020-07-01
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| Series: | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| Subjects: | |
| Online Access: | https://www.ina-jghe.com/index.php/jghe/article/view/698 |
| _version_ | 1827932514110406656 |
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| author | Toar JM Lalisang Yarman Mazni Yefta Moenadjad Sahat Matondang |
| author_facet | Toar JM Lalisang Yarman Mazni Yefta Moenadjad Sahat Matondang |
| author_sort | Toar JM Lalisang |
| collection | DOAJ |
| description | Background: There were only few publications related to pancreaticoduodenal resection (PDR) /Whipple procedure in Indonesia in the past decade.
Method: Retrospectively report of the characteristics and outcomes of PDR performed by Cipto Mangunkusumo Hospital surgical team from 1993 to 2017 were collected.
Results: PDR were performed in 213 patients, with a mean age of 50.6 years and 54.4% patients were females. Predominant preoperative clinical findings were jaundice (68.9%) and mild hypoalbuminemia (69.9%). Biliary decompression was performed in 112 (52.6%) subjects. Average surgical waiting time was 3.5 months. While PDR were performed in 84 (39.5%) subjects, pyloric preserving pancreaticoduodenal technique was predominated in 128 (59.8) and predominated, especially during the latter years. Fifteen (9.0%) cases were benign. Thirty-one (14.6%) subjects underwent relaparotomy, 16 (51.6%) of whom died post-operatively. Overall operative mortality decreased from 16.9% to 5.5% in 2016, while resection rate generally increased over time, ranging from 2 - 21/year. Less than 10% of subjects survived for 5 years, while 20% survived for 24 months. Overall morbidity was 65.1% in 177 survivors, with surgical site infection in 52.5%, pancreatic fistula in 24.2%, and post-pancreatectomy haemorrhage (PPH) as a fatal postoperative complication in 19 (8.9%) cases. Patients who died within 30 days postoperatively had significantly more relaparotomies and PPH (p 0.001).
Conclusion: Prolonged jaundice and mild hypoalbuminemia are dominant characteristics in our Indonesian PDR subjects. Cipto Mangunkusumo Hospital is a high-volume PDR centre and world class hospital. Mortality rates decreased with the increasing resection rates. Relaparotomy and PPH are predictors of poor outcome. |
| first_indexed | 2024-03-13T07:09:40Z |
| format | Article |
| id | doaj.art-74bdd65c9caf4563bbef9c4de33a4ebd |
| institution | Directory Open Access Journal |
| issn | 1411-4801 2302-8181 |
| language | English |
| last_indexed | 2024-03-13T07:09:40Z |
| publishDate | 2020-07-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| spelling | doaj.art-74bdd65c9caf4563bbef9c4de33a4ebd2023-06-06T04:35:14ZengInterna PublishingThe Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy1411-48012302-81812020-07-01202667210.24871/202201966-72664Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade ReportToar JM Lalisang0Yarman Mazni1Yefta Moenadjad2Sahat Matondang3Department of Surgery, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDepartment of Surgery, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDepartment of Surgery, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDepartment of Radiology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaBackground: There were only few publications related to pancreaticoduodenal resection (PDR) /Whipple procedure in Indonesia in the past decade. Method: Retrospectively report of the characteristics and outcomes of PDR performed by Cipto Mangunkusumo Hospital surgical team from 1993 to 2017 were collected. Results: PDR were performed in 213 patients, with a mean age of 50.6 years and 54.4% patients were females. Predominant preoperative clinical findings were jaundice (68.9%) and mild hypoalbuminemia (69.9%). Biliary decompression was performed in 112 (52.6%) subjects. Average surgical waiting time was 3.5 months. While PDR were performed in 84 (39.5%) subjects, pyloric preserving pancreaticoduodenal technique was predominated in 128 (59.8) and predominated, especially during the latter years. Fifteen (9.0%) cases were benign. Thirty-one (14.6%) subjects underwent relaparotomy, 16 (51.6%) of whom died post-operatively. Overall operative mortality decreased from 16.9% to 5.5% in 2016, while resection rate generally increased over time, ranging from 2 - 21/year. Less than 10% of subjects survived for 5 years, while 20% survived for 24 months. Overall morbidity was 65.1% in 177 survivors, with surgical site infection in 52.5%, pancreatic fistula in 24.2%, and post-pancreatectomy haemorrhage (PPH) as a fatal postoperative complication in 19 (8.9%) cases. Patients who died within 30 days postoperatively had significantly more relaparotomies and PPH (p 0.001). Conclusion: Prolonged jaundice and mild hypoalbuminemia are dominant characteristics in our Indonesian PDR subjects. Cipto Mangunkusumo Hospital is a high-volume PDR centre and world class hospital. Mortality rates decreased with the increasing resection rates. Relaparotomy and PPH are predictors of poor outcome.https://www.ina-jghe.com/index.php/jghe/article/view/698hypoalbuminemiaprolonged jaundicewhipple |
| spellingShingle | Toar JM Lalisang Yarman Mazni Yefta Moenadjad Sahat Matondang Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy hypoalbuminemia prolonged jaundice whipple |
| title | Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report |
| title_full | Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report |
| title_fullStr | Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report |
| title_full_unstemmed | Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report |
| title_short | Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report |
| title_sort | characteristics of pancreaticoduodenal resection on periampullary tumor cases by jakarta tertiary hospital team three decade report |
| topic | hypoalbuminemia prolonged jaundice whipple |
| url | https://www.ina-jghe.com/index.php/jghe/article/view/698 |
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