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The Effect of Increase in Clinical Experience on Morbidity and Mortality After Pancreaticoduodenectomy Surgery

Introduction: Pancreaticoduodenectomy surgery is widely accepted and applied worldwide for periampullary tumors. Despite the decline in mortality rates from 40% to 3% with the advances in surgical technique, morbidity is still high (40–50%).  Aim: We aimed to investigate the effect of increased clinical experience on the length of hospital stay, morbidity, mortality, and survival after pancreaticoduodenectomy.   Materials and methods: The files of patients who underwent pancreaticoduodenectomy in our hospital between January 2007 and January 2018 were retrospectively reviewed and divided into four groups by years. Demographics, body mass index (BMI, kg/m2), medical history, preoperative biliary drainage application, surgical technique, histopathological features, postoperative morbidity, mortality, and survival were investigated.   Results:  There was no difference between the groups in terms of age, gender, comorbid disease, history of biliary drainage, surgical technique, and operation time (P > 0.05). The rate of postoperative complications has decreased over the years (P = 0.01). According to the Clavien-Dindo scale, the complication severity decreased significantly over the years (P = 0.05). The overall survival of the patients increased by years (P = 0.03); the Early postoperative mortality rate decreased in the first month (<30 days) (P = 0.04).   Conclusion: With increased clinical experience, morbidity and mortality decrease, overall survival is prolonged after pancreaticoduodenectomy procedure.

