Resultados actuales de la pancreatoduodenectomía para el tratamiento de los tumores periampulares y análisis de factores pronósticos de sobrevida

• Enrique Norero ^[1] ; Eduardo Viñuela ^[1] ; Sergio Báez ^[1] ; Cristian Martínez ^[1] ; Julio Reyes ^[1] ; Rodrigo Kusanovic ^[1] ; Marcel Sanhueza ^[1] ; Gloria Aguayo ^[2] ; Alfonso Calvo ^[1] ; Rose Marie Mege ^[1] ; Mario Caracci ^[1] ; Alfonso Díaz ^[1]
  1. [1] Hospital Sótero del Río Servicio de Salud Metropolitano Sur Oriente Servicio de Cirugía
  2. [2] Hospital Sótero del Río Servicio de Salud Metropolitano Sur Oriente Servicio de Anatomía Patológica
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 139, Nº. 8, 2011, págs. 1015-1024
• Idioma: español
• Títulos paralelos:
  • Results of pancreaticoduodenectomy in the treatment of periampullary tumors
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• Resumen

  • Background: The diagnosis and treatment of periampullary tumors represents a challenge for current medicine. Aim: To review the results of pancreaticoduodenectomy (PDD) in the treatment of periampullary tumors and to identify risk factors that impact the long-term survival. Patients and Methods: We performed a retrospective study of patients who underwent a PDD for periampullary tumors between 1993 and 2009. We reviewed perioperative results and long term survival. We performed a multivariate analysis for long-term survival. Results: A PDD was performed in 181 patients aged 58 ± 12 years (98 females). Piloric preservation was done in 53% and a pancreatogastric anastomosis was used in 94% of cases. Morbidity was 62% and postoperative mortality was 5.5%. Pancreatic cancer was the most frequent pathological finding in 41%, followed by ampullary cancer in 28% and distal bile duct cancer in 16%. Median survival was 17 months, with a five years survival of 24%. Survival for ampullary tumors was 28 months with a five years survival of 32%. The median and five years survival were 14 months and 16% for bile duct cancer and 11 months and 14% for pancreatic cancer. Multivariate analysis identified tumor type (pancreas /bile duct) and lymph node dissemination as independent predictors of mortality. Conclusions: One quarter of patients experienced long term survival. Mortality predictors were tumor type and lymph node dissemination.