Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases

Table 2 Operative data

Variable	Total, n = 1000	First 10 yr, 1993-2002	Second 10 yr, 2003-2012	Last 5 yr, 2013-2017	P-value
Cirrhosis	129 (12.9)	28 (9.3)	62 (14)	39 (15.1)	0.009
Mass size in cm	3 (0.5-15)	3	3	3
< 2	418 (41.8)	123 (41)	174 (39.4)	123 (46.9)	0.14
> 2	582 (58.2)	177 (59)	268 (60.6)	137 (53.1)
Pancreatic texture
Soft	596 (59.6)	190 (63.3)	263 (59.5)	143 (55.4)	0.23
Firm	404 (40.4)	110 (36.7)	179 (40.5)	115 (44.6)
Median pancreatic duct diameter in mm	5 (1-15)				0.47
< 3	313 (31.3)	97(32.3)	137 (30.9)	79 (30.6)
> 3	687 (68.7)	20367.7)	305 (60.1)	179 (69.4)
Pancreatic duct to posterior border in mm					0.45
< 3	421 (42.1)	128 (42.7)	185 (41.9)	108 (41.9)
> 3	579 (57.9)	172 (57.3)	257 (58.1)	150 (58.1)
Pancreatic stump mobilization in cm	2 (1-4)	2	2	2	0.45
CBD diameter in mm	15 (5-30)	15	15	15	0.06
Type of reconstruction
PG	791 (79.1)	235 (78.3)	417 (94.3)	139 (53.9)	0.0001
Simple PJ	163 (16.3)	65 (21.7)	25 (5.7)	73 (28.3)
Isolated loop PJ	46 (4.6)	0	0	46 (17.8)
Duct to mucosa	134 (13.4)	9 (3)	65 (14.7)	60 (23.3)
Invaginated type with duct to mucosa	644 (64.4)	234 (78)	250 (65.6)	160 (62)	0.0001
Invaginated type without duct to mucosa	221 (22.1)	57 (19)	126 (28.5)	38 (14.7)
No anastomosis	1 (0.1)	0	1 (0.2)	0
Standard approach	908 (90.8)	277 (92.3)	388 (87.8)	243 (94.7)	0.004
Posterior approach	92 (9.2)	23 (7.7)	54 (12.2)	15 (5.8)
Complete meso-pancreatectomy	574 (57.4)	83 (27.7)	233 (52.7)	258 (100)	0.0001
Laparoscopic assisted PD	11 (1.1)	0	0	11 (4.3)	0.0001
Complete laparoscopic PD	10 (1)	0	0	10 (3.9)
Vascular resection	12 (1.2)	0	4 (0.9)	8 (3.1)	0.003
Primary anastomosis	0	0	3 (0.7)	8 (3.1)
Gortex	0	0	1 (0.2)	0
Operative time in h	5 (3.5-10)	6	5	5	0.001
Blood loss in cc	500 (50-4000)	500	400	300	0.001

Data are presented as n (%) or n (range). PD: Pancreaticoduodenectomy; PG: Pancreaticogastrostomy; PJ: Pancreaticojejunostomy.