Evaluation of Safety of Pancreaticoduodenectomy for Patients with Benign Conditions

Introduction Pancreaticoduodenectomy (PD) is a complex and high-risk surgical procedure with substantial mortality and morbidity. Selected patients with benign conditions may need PD in case of ambiguous tissue diagnosis. There is limited data in the literature on the outcomes of patients with benign conditions undergoing PD. The purpose of this study is to determine the safety of PD in patients with benign conditions. Materials & methods From 2013 to 2018, 38 patients undergone pancreatectomy (PD [Group 1], n = 9; Distal pancreatectomy [Group 2], n = 29) were retrospectively reviewed in a prospectively collected database. Short-term outcome in terms of procedure-related complication was evaluated. Results There was no significant difference in demographic features in both groups. Majority of patients was female (Group1: 66.6%, Group 2: 75.8%) and had no significant comorbidity (Group 1: 88.8%, Group 2: 82.4%). Patients in group 1 rarely presented with obstructive jaundice (median bilirubin level = 11.1 umol/L). Disease spectrum in group 1 included insulinoma (n = 1), pancreatic tuberculosis (n = 1), Ig G4-related disease (n = 1), mucinous cystadenoma (n = 1), splenic aneurysm (n = 1), serous cystadenoma (n = 2) and benign neuroendocrine tumor (n = 2). Group 1 had significantly longer operation duration (470 min vs. 287 min, p < 0.001), longer hospital stay (20 days vs. 14 days, p = 0.032) and more interoperative blood loss (600 ml vs. 350 ml, p = 0.013) than group 2. The postoperative pancreatic fistula rate of Group 1 was significantly lower than Group 2 (Grade A: 33.3% vs. 65.5%; Grade B: 0% vs. 24.1%; Grade C: 11.1% vs. 0%), (p = 0.004). There was no significant difference in other severe postoperative complications between the two groups. There was also no hospital mortality in both groups. Conclusion Pancreaticoduodenectomy can be safely performed for patients with benign diseases with postoperative pancreatic fistula rate.