Hughes et al identified a number of preoperative factors associated with complications following a pancreaticoduodenectomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from Loyola University Medical Center in Maywood. Illinois.


Patient selection: pancreaticoduodenectomy (452 patients)



(1) pancreatic leak

(2) intra-abdominal abscess

(3) wound infection

(4) bile leak

(5) hemorrhage

(6) death within 30 days


Preoperative risk factors for postoperative complications (determined in the 7 days prior to surgery):

(1) anemia (hemoglobin < 14 g/dL)

(2) normal serum alkaline phosphatase (elevated level associated with reduced risk)


Operative risk factors for postoperative complications:

(1) blood loss > 1,000 mL


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