Outcome of Pancreaticoduodenectomy in Cirrhotic Patients

Background: Cure-only treatment for people with malignant disorders pertaining to the pancreas and surrounding region around the ampulla is pancreaticoduodenectomy (PD), a complicated procedure.Aim: The purpose of this study was to investigate the outcomes and factors of pancreaticoduodenectomy in cirrhotic patients at Hepato-Pancreato-Biliary (HPB) Department, Menoufia University National Liver Institute.Patients and Methods: This retrospective study was carried out on 63 cirrhotic patients who were Child class A patients and early B (patient score blow eight) who underwent pancreaticoduodenectomy at Hepato-Pancreato-Biliary (HPB) Department, National Liver Institute, Menoufia University from the beginning of 2016 to the end of 2022.Non-cirrhotic patients, cirrhotic patients with Child class B (score more than eight) and class C were excluded.Assessment of degree of liver cirrhosis was done according to Child-Pugh classification and MELD score.The data were gathered from the medical records in our HPB division.Results: There were no statistically significant differences between Child classes A and B in postoperative complications or length of stay.Hospital stay was longer in cases with MELD score >10 compared to cases with MELD score ≤10.Pancreatic fistula, postpancreatectomy hemorrhage and overall morbidity were significantly more in cases with portal hypertension compared to cases with no portal hypertension, while insignificant statistical differences were found between cases regarding Delayed gastric emptying (DGE), postoperative dependencies and mortality related to operation.Conclusion: When treating carefully chosen cirrhotic individuals, pancreatoduodenectomy may be an option.Patients who have preoperative radiographic indications of portal hypertension should get special care since their outcomes are dismal regardless of MELD or Child score.