Does the War in Ukraine Affect Surgical Outcomes of Treating Pancreatic Cancer?

Introduction: Surgery remains the main method to cure cancer. It`s not known if complex pancreatic surgery could be performed safely during the war. Methods: Patients who underwent surgeries with curative intent for pancreatoduodenal malignancies in 2022 were identified in the prospective database. Demographic and postoperative data of treatment after Russian invasion in February 2022 were analyzed. Instances of war-related incidents were sought. Results: 54 patients were operated with pancreatobiliary malignancies at our clinic in 2022. We identified 33 patients with primary pancreatic cancer, 5 with distal bile duct cancer, and 16 with other pancreatobiliary tumors. 22 (40%) of the patients were male, the mean age was 60 (SD ±9) years. We performed 43 Whipple’s, 6 distal resections, 5 pancreatectomies. The average operative time was 408,5 (SD ± 158,9 ) minutes. The median blood loss was 277 (SD ± 184) ml. The median ICU stay was 1 day (range 1-12), the median postoperative hospital stay was 15 (range 6-56) days. Postoperative complications grade ≥IIIA occurred in 19 (35%) of cases, mortality rate was 8 (15%). Most often complications were: pancreatic fistula B∖C - 8 (15%), biliary fistula - 6 (11%), gastroenterostomy leakage - 5 (9%), postoperative bleeding - 4 (7%), abscess - 4 (6%). Leading causes of deaths were: sepsis - 4 (7%) and bleeding - 2(4%). Conclusions: Surgical morbidity and mortality after complex pancreatic surgery during wartime were similar to that reported in literature. There were no “war-related” complications. It was possible to provide surgical treatment for the patients during active war in Ukraine.