Resultados clínico-cirúrgicos e sobrevida de pacientes submetidos a gastroduodenopancreatectomias em um hospital universitário

Abstract

Pancreaticoduodenectomy (PD), a highly complex procedure, is the main treatment for resectable tumors of the pancreatic head and periampullary region. Advances in surgical and anesthetic techniques, together with perioperative intensive care, have reduced patient mortality over the past decades, although morbidity remains high. The main objectives of this study were to analyze the clinical and epidemiological characteristics, as well as the survival, of patients undergoing PD. This was a longitudinal, observational, and analytical study, with retrospective data collection from the medical records of 110 patients operated on between 2015 and 2023 at Hospital Universitário Walter Cantídio (HUWC/UFC). Logistic regression analysis identified the following as significant risk factors for death: male sex, dyslipidemia, smoking, histological diagnosis of pancreatic adenocarcinoma or cholangiocarcinoma, and the presence of positive lymph nodes. Perioperative mortality (30 days) was 3.63%, and estimated overall survival was 75.5% at 6 months, 68% at 12 months, 64% at 3 years and 58% at 5 years, with a median overall survival of 48.53 months. Regarding postoperative complications, a high morbidity rate was observed, affecting 83.6% of patients. The main complications identified were infections (60.9%), pancreatic fistula (41.8%), delayed gastric emptying (25.4%), and bleeding (22.7%). Less frequent complications included pulmonary complications (6.3%) and biliary fistula (4.5%). The results of this case series, with in-hospital mortality below 5%, were similar to those reported by major international centers. HUWC is a center for teaching, research, and patient care, and these data are essential to support protocols and contribute to optimizing survival and reducing morbidity in these major surgical procedures.