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abstract
Objectives: To investigate the incidence of pancreatic
leak and other postoperative complications after distal pancreatectomy
performed during debulking surgery for gynecologic malignancies.
Methods: All patients who underwent distal
pancreatectomy during their debulking surgery from 2010 to 2014 were
identified. Postoperative complications within 30 days and pancreatic
leak within 120 days after surgery were included.
Results: Eighteen patients met the inclusion criteria.
The median age was 62 years (36–78 years). Four patients (22%) were
admitted to the intensive care unit, and the average length of hospital
stay was 10 days. Nine patients developed postoperative complications
within 30 days after surgery (50%) with no perioperative mortality up to
90 days after surgery. No patients required reexploration.
The median
time from surgery to initiation of chemotherapy was 39.5 days. Two
patients developed pancreatic leak (11%). Among the patients who
developed pancreatic leak, the average length of hospital stay was 11.5
days and time to initiation of chemotherapy was 75 days. Conservative
management was successful in both cases.
Conclusion: In this series, the rate of pancreatic
leak was lower than previously reported with no perioperative mortality
or surgical reexploration. However, the time to initiation of
chemotherapy was delayed in those who developed pancreatic leak. These
data are important in patient counseling and decision making at the time
of debulking surgery. Gynecologic oncologists considering distal
pancreatectomy should be familiar with perioperative management of these
patients.
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