Immediate outcomes of multivisceral surgeries involving pancreaticoduodenectomy

Aim. To investigate the immediate outcomes of multivisceral surgeries with pancreaticoduodenectomy for tumors of various localizations.

Materials and methods. From January 2011 to April 2024, 251 patients underwent multivisceral surgery with pancreaticoduodenectomy for tumors of different localizations. The control group consisted of 832 patients who underwent standard pancreaticoduodenectomy. Intergroup and intragroup comparative analyses were performed.

Results. In the main group, postoperative complications developed in 165 patients (65.7%), with complications classified as ≥3 (severe complications) according to the Clavien-Dindo classification occurring in 97 patients (38.6%). 18 patients (7.2%) died postoperatively. In the control group, severe postoperative complications were recorded in 36.6% of patients, and 49 patients (5.9%) died. Risk factors for postoperative complications classified as ≥3 included obesity (p = 0.026), ischemic heart disease (p = 0.033), postinfarction cardiosclerosis (p = 0.008), combination with hemigastrectomy (p = 0.031), small diameter of the pancreatic duct (p < 0.001), and soft pancreas (p < 0.001). Significant risk factors for postoperative mortality included diabetes mellitus (p = 0.002), colon resection (p = 0.002), and density of the pancreatic stump (p = 0.012).

Conclusion. Multivisceral surgeries with pancreaticoduodenectomy vary in the number of resected and excised organs, are accompanied by an incidence of postoperative complications classified as ≥3 according to Clavien–Dindo (38.6%) and a mortality rate (7.2%) comparable to that in the control group. Overall, the tolerability of these complex and traumatic surgical interventions by patients is found to be acceptable, provided they are performed only in specialized institutions.

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