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The group of patients who underwent pancreaticduodenectomy for management of periampullary tumors and required surgical reintervention afterwards for management of procedure-related complications as pancreatic fistula, bleeding, abdominal collection, biliary fistula, gastric fistula.

The group of patients who underwent pancreaticoduodenectomy for management of periampullary tumors and did not require surgical reintervention.

Mandatory surgical management of complications after pancreatico-duodenectomy through peritoneal lavage, draiange, repair of fistula, completion pancreatectomy, control of bleeding, bowel resection, and feeding jejunostomy.

Surgical re-interventionafter pancreaticoduodenectomy

Ayman El Nakeeb, md

The aim of this study is to outline the incidence of early and late reoperation after PD, examine the risk factors for early surgical intervention and its impact on the surgical outcome, hospital stay, diseases recurrence and patient survival, address variable indications for late readmission and reoperation after PD and its impact on patient survival and disease recurrence.

This is a retrospective cohort study of all patients who underwent PD for periampullary tumors in Gastrointestinal Surgical Center (GISC), Mansoura University, Egypt in the period between 2000 and 2018.The exclusion criteria included any patients with locally advanced periampullary tumor, metastases, patients with advanced liver cirrhosis (Child B or C), malnutrition, or coagulopathy.

Patient data were recorded in a prospectively maintained database. Preoperative variables included; age, sex, body mass index, patients' symptoms and signs, laboratory tests, tumor markers and preoperative biliary drainage. Intraoperative variables included; liver status, tumor size, pancreatic duct diameter, texture of the pancreas, operative time, blood loss, pancreatic reconstruction method and blood transfusion. Postoperative variables included postoperative complications, drain amylase, liver function, day to resume oral feeding, postoperative stay, re-exploration, hospital mortality, postoperative pathology, and surgical safety margins.

Data regarding reoperation included incidence, male to female ratio, hospital stay, interval to reoperation, number of explorations, indication of reoperation and surgical management, and postoperative outcome in terms of morbidity and hospital stay. Follow-up was carried out one week postoperatively, 3 months, 6 months and then after one year. The minimum duration of follow up was 2 years. Follow up was done by thorough history taking, clinical examination and abdominal CT in case of suspicious lesions on pelvi-abdominal ultrasound.

Reoperation After Pancreaticoduodenectomy

Surgical Intervention After Pancreaticoduodenectomy: Incidence, Indications, Risk Factors and Outcome

The data will be prepared as a research paper and the cohort results will be published in a scientific journal.

The duration between surgical intervention to patient death

Duration between surgery and recurrence of periampullary tumors based on radiological or endoscopic investigations.

duration between reoperation surgery to discharge from hospital

complications after reoperation including intr- or extra-luminal hemorrhage, pancreatic or gastric fistula, biliary leakage, thromboembolic diseases, and wound infection

Factors that increase the probability that the patient undergoing pancreaticoduodenectomy would be at higher risk for reoperation

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Reoperation After Pancreaticoduodenectomy	NCT04387903	Periampullary C... Pancreatic Canc...	Surgical re-int...	15 Years - 70 Years	Mansoura University
Reoperation After Pancreaticoduodenectomy	NCT04387903	Periampullary C... Pancreatic Canc...	Surgical re-int...	15 Years - 70 Years	Mansoura University

Spots Global Cancer Trial Database for pancreaticoduodenectomy, pancreatic fistula, pancreatic cancer, reoperation