Survival outcome and prognostic factors after pancreatoduodenectomy for distal bile duct carcinoma: a retrospective multicenter study

摘要: Pancreatoduodenectomy is the most common operative procedure performed for distal bile duct carcinoma. Data on outcome after surgery this rare malignancy scarce, especially from western countries. The purpose of study to explore prognostic factors and pancreatoduodenectomy Patients receiving carcinoma were identified institutional databases five German one Russian academic centers pancreatic surgery. Univariable multivariable general linear model, Kaplan-Meier method, Cox regression used identify postoperative mortality overall survival. N = 228 patients operated 1994 2015 included. Reoperation (OR 5.38, 95%CI 1.51–19.22, p = 0.010), grade B/C postpancreatectomy hemorrhage 3.73, 1.13–12.35, p = 0.031), fistula 4.29, 1.25–14.72, p = 0.038), advanced age 4.00, 1.12–14.03, p = 0.033) independent risk in-hospital in analysis. Median survival was 29 months, 5-year 27%. Positive resection margin (HR 2.07, 1.29–3.33, p = 0.003), high tumor 1.71, 1.13–2.58, lymph node 1.68, 1.13–2.51, p = 0.011), distant metastases 2.70, 1.21–5.58, p = 0.014), as well severe non-fatal complications 1.64, 1.04–2.58, negative Distant positive are strongest carcinoma; thus, with curative intent only warranted local disease, where R0 feasible.