Bleeding After Cephalic Duodeno-Pancreatectomy

Cephalic duodenopancreatectomy (CPD) is a major surgical procedure with a high morbidity and mortality rate. Post-CPD hemorrhage is one of the most serious complications. The aim of this study was to determine its incidence and the factors associated with its occurrence. We enrolled 32 patients. Mean age was 62 years, sex ratio 0.68 and mean operative time 362 min. The mortality rate was 34%. The overall morbidity rate was 54%, and the rate of specific complications was 44%, dominated by haemorrhage (31%, responsible for 9% of mortality), grade A haemorrhage in 3% of patients, grade B haemorrhage in 6% and grade C haemorrhage in 16%. In the univariate study, male gender(p=0.045), pancreatic fistula(p=0.037) and operative time(p=0.017) were significantly associated with hemorrhage. After construction of the curve, the threshold for operative time was 395min. In multivariate analysis, pancreatic fistula and operative time were retained.