Resultados actuales de la pancreatoduodenectomía para el tratamiento de los tumores periampulares y análisis de factores pronósticos de sobrevida

background: the diagnosis and treatment of periampullary tumors represents a challenge for current medicine. aim: to review the results of pancreaticoduodenectomy (pdd) in the treatment of periampullary tumors and to identify risk factors that impact the long-term survival. patients and methods: we performed a retrospective study of patients who underwent a pdd for periampullary tumors between 1993 and 2009. we reviewed perioperative results and long term survival. we performed a multivariate analysis for long-term survival. results: a pdd was performed in 181 patients aged 58 ± 12 years (98 females). piloric preservation was done in 53% and a pancreatogastric anastomosis was used in 94% of cases. morbidity was 62% and postoperative mortality was 5.5%. pancreatic cancer was the most frequent pathological finding in 41%, followed by ampullary cancer in 28% and distal bile duct cancer in 16%. median survival was 17 months, with a five years survival of 24%. survival for ampullary tumors was 28 months with a five years survival of 32%. the median and five years survival were 14 months and 16% for bile duct cancer and 11 months and 14% for pancreatic cancer. multivariate analysis identified tumor type (pancreas /bile duct) and lymph node dissemination as independent predictors of mortality. conclusions: one quarter of patients experienced long term survival. mortality predictors were tumor type and lymph node dissemination.