Current status and problems of perioperative complications of preoperative treatment for pancreatic head cancer

Abstract

In recent years, preoperative therapy for pancreatic cancer has been increasing. We retrospectively analyzed 184 consecutive patients with pancreatic head cancer during 2008-2018, 94 patients underwent upfront surgery and 90 patients received preoperative therapy. The rate of preoperative therapy was 72.3％ in last 5 years. The preoperative therapy group had lower age, high smoking rate, anemia, high platelet-lymphocyte ratio, long operative time, high blood transfusion rate, and high portal vein resection rate than upfront surgery group. There was no difference in postoperative complications including SSI, however, Clavien-Dindo Ⅳa was significantly higher in the preoperative therapy group (0.0％ vs 5.5％, P=0.02). In multivariate analysis, age . 68 years, operation time . 548 minutes, BMI . 21.5, and ALB ＜3.5g/dL were independent risk factors for SSI. Preoperative therapy was not a risk factor for SSI in pancreaticoduodenectomy.