# Analysis of Short-term Outcomes of Pancreatic Resections from a Low Volume Centre in a Tier II City in India

## TL;DR

This study examines the short-term outcomes of pancreatic surgeries at a low-volume center in India, finding that safe results are possible with skilled teams and careful patient selection.

## Contribution

The study provides insights into pancreatic resection outcomes from a low-volume center in a Tier II Indian city.

## Key findings

- Post-operative complications occurred in 24.4% of cases, with pancreatic fistula being the most common.
- Perioperative mortality was 7.3%, comparable to low-volume centers but worse than high-volume ones.
- Minimally invasive surgery was attempted in only 4.9% of cases.

## Abstract

Pancreatic cancer surgery represents the holy grail of hepatobiliary surgery and is the only option of curative treatment for malignancies involving this particular organ. This study aims to analyse the short-term outcomes of across the spectrum of surgeries performed for pancreatic neoplasms at a low volume hepatobiliary centre in eastern India. This is a retrospective study from our centre, from 1st January 2019 to 31st October 2024. Patients were identified from a prospectively maintained surgical database and electronic medical records, and data was collected from Electronic Medical Records. We identified 41 patients who underwent surgical resections during the study period. Median age was 56 years. Pre-operative biliary drainage was required in 24 (58.5%) cases. Pancreatico-duodenectomies represented with majority of cases (87.8%), followed by distal pancreas resections (2.4%), total pancreatectomy (2.4%) and ampullectomy (2.4%). Minimally invasive approach was attempted in 2 patients (4.9%). Post-operative complications and their incidences were post-operative pancreatic fistula (POPF) 26.8%, chyle leak 9.7%, biliary leaks 7.3%, delayed gastric emptying 19.4%, post pancreatectomy haemorrhage 4.8%, bowel-related complications 7.3, and surgical site infection 9.8%. Significant post-operative morbidity occurred in 24.4% of cases. Perioperative mortality rate was 7.3%. Although a low volume centre, our results are comparable to published literature for low volume centres, though worse than high volume centres. Safe outcomes are achievable at low volume centres with trained and dedicated surgeons, anaesthesiologists and proper patient selection.