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Journals / Doğu Karadeniz Sağlık Bilimleri Dergisi / 2026 / Cilt: 5 Sayı: 2

Pancreatic and Periampullary Cancer Surgery: Early Outcomes and Clinical Implications from a Single-Center Experience

Pankreas ve Periampuller Kanser Cerrahisi: Tek Merkez Deneyiminden Elde Edilen Erken Sonuçlar ve Klinik Etkiler

Hamza Çınar(PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0003-1748-1392
Utku Ozgen(PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-6481-1473
Pages
127–147
Publication Date
2026-07-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall 30-day and 90-day mortality rates were 11.8% and 14.7%, respectively.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: Pancreaticoduodenectomy (PD) remains the standard surgical treatment for pancreatic head and periampullary malignancies, but it is associated with significant postoperative morbidity and mortality.
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Key Findings & Data:Methods: This retrospective single-center study included 34 consecutive patients who underwent curative pancreaticoduodenectomy for pancreatic or periampullary malignancies between January 2024 and June 2026.
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Conclusion & Impact:Overall 30-day and 90-day mortality rates were 11.8% and 14.7%, respectively.
🔬Design:Modeling & Simulation
📍Scope:2024 Verileri
⚙️Variables:Pankreas kanseri · Periampuller kanser · pankreatikoduodenektomi

Abstract

Background: Pancreaticoduodenectomy (PD) remains the standard surgical treatment for pancreatic head and periampullary malignancies, but it is associated with significant postoperative morbidity and mortality. This study evaluated early postoperative outcomes following PD and factors associated with complications and mortality. Methods: This retrospective single-center study included 34 consecutive patients who underwent curative pancreaticoduodenectomy for pancreatic or periampullary malignancies between January 2024 and June 2026. Demographic, perioperative, pathological, and postoperative data were analyzed. Clinically significant postoperative pancreatic fistula (POPF), bile leakage, postpancreatectomy bleeding (PPH), and 30- and 90-day mortality were evaluated. Univariate analyses were performed to identify factors associated with postoperative outcomes. Results: The median age of the patients was 64, and 64.7% were male. The most frequent histopathological diagnosis was pancreatic ductal adenocarcinoma (50.0%). POPF, bile leakage, delayed gastric emptying, and intraabdominal abscess each occurred in 17.6% of patients, while PPH developed in 14.7%. Overall 30-day and 90-day mortality rates were 11.8% and 14.7%, respectively. Low body mass index (BMI) was significantly associated with both 30-day (p=0.003) and 90-day mortality (p=0.002). Longer operating time (p=0.038) and tumor type/location (p=0.044) were associated with 30-day mortality, while firm pancreatic tissue was significantly associated with PPH (p=0.048). No significant association was observed between preoperative bile drainage and postoperative outcomes. Conclusions: PD can be performed in specialized centers with acceptable early postoperative outcomes. Low BMI is the strongest predictor of postoperative mortality, highlighting the importance of preoperative nutritional assessment and optimization. Larger prospective multicenter studies are needed to confirm these findings.

Özet

Amaç: Pankreatikoduodenektomi (PD), pankreas başı ve periampuller maligniteler için halen standart cerrahi tedavi olarak kabul edilmektedir; ancak bu işlem, önemli ölçüde postoperatif morbidite ve mortalite ile ilişkilidir. Bu çalışmada, PD sonrası erken postoperatif sonuçlar ile komplikasyonlara ve mortaliteye ilişkin faktörler değerlendirilmiştir. Yöntem: Bu retrospektif, tek merkezli çalışmaya, Ocak 2024 ile Haziran 2026 tarihleri arasında pankreas veya periampuller maligniteler nedeniyle küratif pankreatikoduodenektomiye tabi tutulan ardışık 34 hasta dahil edilmiştir. Demografik, perioperatif, patolojik ve postoperatif veriler analiz edilmiştir. Klinik olarak anlamlı postoperatif pankreatik fistül (POPF), safra kaçağı, pankreatektomi sonrası kanama (PPH) ile 30 ve 90 günlük mortalite değerlendirilmiştir. Postoperatif sonuçlarla ilişkili faktörleri belirlemek için tek değişkenli analizler yapılmıştır. Bulgular: Hastaların medyan yaşı 64 idi ve %64,7’si erkekti. En sık görülen histopatolojik tanı pankreas duktal adenokarsinomdu (%50,0). POPF, safra kaçağı, gecikmiş mide boşalması ve karın içi apse, hastaların her birinde %17,6 oranında görülürken, PPH ise %14,7 oranında gelişti. Genel 30 günlük ve 90 günlük mortalite oranları sırasıyla %11,8 ve %14,7 idi. Düşük vücut kitle indeksi (VKİ), hem 30 günlük (p=0,003) hem de 90 günlük mortalite (p=0,002) ile anlamlı bir şekilde ilişkiliydi. Daha uzun ameliyat süresi (p=0,038) ve tümör tipi (p=0,044) 30 günlük mortalite ile ilişkiliyken, sert pankreas dokusu PPH ile anlamlı bir ilişki göstermiştir (p=0,048). Ameliyat öncesi safra drenajı ile ameliyat sonrası sonuçlar arasında anlamlı bir ilişki gözlenmemiştir. Sonuçlar: PD, uzmanlaşmış merkezlerde kabul edilebilir erken dönem sonuçlarla uygulanabilir. Düşük BMI, postoperatif mortalitenin güçlü bir belirtecidir; bu da preoperatif beslenmenin değerlendirmesi ve optimizasyonunun önemini vurgulamaktadır. Bu bulguları doğrulamak için daha geniş kapsamlı prospektif çok merkezli çalışmalara ihtiyaç vardır.

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Cite This Article

Çınar, H., Ozgen, U. (2026). Pancreatic and Periampullary Cancer Surgery: Early Outcomes and Clinical Implications from a Single-Center Experience. Doğu Karadeniz Sağlık Bilimleri Dergisi, Cilt: 5 Sayı: 2, 127–147. https://doi.org/10.59312/ebshealth.1969980

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