Abstract

CACERES, Jazmín; ORTIZ, Williams; RECALDE, Rodney  and  ALMIRON, Desirée. Post-operative mortality of cephalic duodenopancreatectomy in an intensive care unit. Rev. Inst. Med. Trop. [online]. 2024, vol.19, n.1, pp.27-32. ISSN 1996-3696.  https://doi.org/10.18004/imt/2024.19.1.27.

Introduction: Cephalic pancreaticoduodenectomy or Whipple surgery has been the elective surgical procedure as a treatment for neoplastic pathologies of the pancreas, duodenum and bile ducts. Despite advances in surgical techniques, multidisciplinary management continues to be a great challenge. Materials and Methods: Analytical, retrospective, cross-sectional study of postoperative cephalic duodenal-pancreatectomy patients over 18 years of age, admitted to an Intensive Care unit, from January 2022 to July 2023. Variables evaluated: sociodemographic characteristics (age, sex); associated comorbidities; variables of interest in the ICU (SOFA, APACHE, days of ICU admission, days of hospitalization, requirement for orotracheal intubation IOT, days of IOT, requirement for vasopressors), outcome in ICU; surgical variables of interest: duration of surgery, surgical complications. Results: 24 patients were included. Median age: 66 years (min: 35; Max: 85; IQR: 59-77); 14 (58%) female. Most frequent comorbidities: High blood pressure 17 (71%), Diabetes Mellitus 26 (25%), Heart disease 3. SOFA at admission average of 4; (min:1; Max: 11; DS:3); APACHE upon admission: average of 15; (min:6; Max: 24; DS: 4); Mean ICU stay was 6 days (min: 1; Max: 68; SD: 14). There were 5 (21%) deaths. Factors associated with mortality were the use of vasopressors (p=0.013), acute renal failure (p=0.009), surgical site infection (p=0.023), and a mean estimated SOFA of 9 (p=0.0012). Conclusion: Multidisciplinary management of patients undergoing Whipple surgery is essential in order to optimize results, preventing the appearance of complications, and thus reducing their morbidity and mortality.

Keywords : Pancreaticoduodenectomy; Digestive System Surgical Procedures; Pancreatic Neoplasms; Carcinoma, Pancreatic Ductal.

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