Analysis of postoperative course after pancreatic resections – experience of one centre

Introduction
Pancreatic resections belong to the most difficult surgical procedures and are still burdened with a high percentage of complications.

Aim of the research
To analyse both the medical records of patients qualified for surgical treatment and the postoperative course after procedures of radical resection of the pancreas, with consideration of the most severe complications.

Material and methods
Postoperative courses were analysed in 100 patients who had undergone pancreatic resection.

Results
The most frequent indications for pancreatic resection were: cancer of the ampulla of Vater (30), pancreatic cancer (24), inflammatory tumours (16), and benign cystic tumours (12). In 8 cases, pancreatic resection (distal) was an element of the surgery due to advanced gastric cancer, while the remaining were: lymphoma (2), neuroendocrine tumour (2), adenoma with high-grade dysplasia involving the ampulla of Vater (2), GIST (1), IPMN (1), fibromatosis (1), and injury (1). The most frequently performed surgery was partial resection of the organ (73: proximal resection – 35, distal resection – 38). Total pancreatectomy was performed in 20 patients, and in 3 patients the surgery was limited to resection of the tumour. The dominant postoperative complications were pancreatic fistulas (9%) and haemorrhages (5%). Only one case of fistula was surgically treated. Surgical intervention was necessary in all cases of haemorrhagic complications (in 2 patients – several times). During the postoperative period 5 deaths were registered (5%).

Conclusions
Pancreatic surgery remains a very difficult discipline, which requires not only excellent surgical technique, but also skill in the management of postoperative complications.