Decreasing Length of Stay After Pancreatoduodenectomy

Abstract

SINCE THE classic description of pancreatoduodenectomy (PD) in 1935,¹ this procedure has been associated with substantial morbidity and mortality. As recently as the 1970s, the average mortality was 20%.² Since that time, improved understanding of the pathophysiological features of the disease processes involved and improvements in surgical technique and perioperative care have contributed to an improved mortality rate. Several investigators^3-11 have described the ability of experienced surgeons and high-volume hospitals to perform this procedure with minimal mortality, less than 4% in many centers. Unfortunately, reported complication rates have remained relatively constant, ranging from 35% to more than 50%.^4,7,12-15