Pancreaticoduodenectomy: A study from India on the impact of evolution from a low to a high volume unit

Table 3 Comparative analyses of features in the perioperative period during the progress from a low to a high volume PD centre, n (%)

Variable	Low volume (< 10 PDs/yr), n = 20	Medium volume (10-24 PDs/yr), n = 44	High volume (≥ 25 PDs/yr), n = 136
Preoperative
Triple phase CECT abdomen/pelvis	10 (50)	40 (90.9)	136 (100)
CA 19.9	10 (50)	44 (100)	136 (100)
Operative
Classical Whipple	14 (70)	12 (27.3)	4 (2.9)
PPPD	6 (30)	32 (72.7)	132 (97.1)
With portal vein resection	0 (0)	0 (0)	4 (2.9)
With right hemicolectomy	0 (0)	2 (4.5)	6 (4.4)
Pancreaticojejunostomy
Duct to mucosa	17 (85)	5 (11.4)	0 (0)
Dunking	3 (15)	39 (88.6)	136 (100)
Use of pyloric dilatation	0 (0)	32 (72.7)	132 (97.1)
Use of omental flap[8]	0 (0)	10 (22.7)	136 (100)
No of abdominal drains
1 drain	4 (20)	39 (88.6)	136 (100)
2 drains	16 (80)	5 (11.4)	0 (0)
Feeding jejunostomy	15 (75)	26 (59.1)	10 (7.4)
Octreotide 0.1 mg S/C × 3 times for 1 wk	15 (75)	10 (22.7)	0 (0)
Postoperative
Fast track approach[10]	0 (0)	16 (36.4)	126 (92.6)

CA 19.9: Carbohydrate antigen 19.9; PPPD: Pylorus preserving pancreaticoduodenectomy.