Udo, A. (Annemarije) (2013) De chirurgische behandeling van peri-ampullaire tumoren in de Isala klinieken te Zwolle. Mortaliteit, morbiditeit & middellange termijnoverleving. thesis, Medicine.
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Abstract
Background: The Whipple procedure and the PPPD are the only procedures that are intentionally curative in peri-ampullary carcinoma. They are highly complex procedures, known for their high mortality and morbidity. The purpose of this study was to determine the mortality, morbidity and the medium-term survival of the Whipple procedure and PPPD in the Isala Clinics in Zwolle. The Isala Clinics are one of the major tertiary hospitals in the Netherlands, where this form of complex surgery has been done for quite a long time. Method: Patients who underwent a Whipple procedure or a PPPD due to a peri-ampullary tumor were analyzed through this retrospective cohort study. The study enrolled a total of 122 patients from 2005 until 2013. Our results were compared with the results from the recent Dutch study by Cieslak et al (1) and with outcomes from international literature. Results: Of the 122 patients, 72.1% had a complication. There were 4 patients (3.3%) with a relevant pancreatic fistula, 4 (3.3%) had bile leakage, 24 (19.7%) had a relevant gastroparesis and finally there were 3 patients (2.5%) with post-operative bleeding. The 30-day mortality was 1.6% (n = 2 patients), while the hospital mortality was 2.5% (n = 3 patients). Respectively the 1-, 2- and 3-year survival was 68%, 44% and 27%. Conclusion: The results of our study, focussing on the surgical treatment of peri-ampullary tumors, show a low 30-daymortality and hospital mortality. These results are consistent with data from the international literature and are lower compared to national figures. The relevant morbidity is also lower than the national outcomes. The overall 1-, 2- and 3-year survival rates were low, as expected with these types of tumors. The Isala Clinics show that they can meet the national standards and quality requierments, both in peri-operative care as well as in survival.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Patijn, Dr. G.A. and Isala klinieken, Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:49 |
| Last Modified: | 25 Jun 2020 10:49 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1044 |
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