El Nakeeb A, Sultan AM, Salah T, El Hemaly M, Hamdy E, Salem A, Moneer A, Said R, AbuEleneen A, Abu Zeid M, Abdallah T, Abdel Wahab M. Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy. World J Gastroenterol 2013; 19(41): 7129-7137 [PMID: 24222957 DOI: 10.3748/wjg.v19.i41.7129]
Corresponding Author of This Article
Ayman El Nakeeb, MD, Associate Professor of general surgery, Gastroenterology surgical center, Mansoura University, Gehan street, Mansoura 35516, Egypt. elnakeebayman@yahoo.com
Research Domain of This Article
Surgery
Article-Type of This Article
Brief Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 7, 2013; 19(41): 7129-7137 Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7129
Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy
Ayman El Nakeeb, Ahmad M Sultan, Tarek Salah, Mohamed El Hemaly, Emad Hamdy, Ali Salem, Ahmed Moneer, Rami Said, Ahmed AbuEleneen, Mostafa Abu Zeid, Talaat Abdallah, Mohamed Abdel Wahab
Ayman El Nakeeb, Ahmad M Sultan, Tarek Salah, Mohamed El Hemaly, Emad Hamdy, Ali Salem, Ahmed Moneer, Rami Said, Ahmed AbuEleneen, Mostafa Abu Zeid, Talaat Abdallah, Mohamed Abdel Wahab, Gastroenterology surgical center, Mansoura University, Mansoura 35516, Egypt
Author contributions: El Nakeeb A designed the research; El Nakeeb A, Salah T, Salem A, El Hemaly M, Hamdy E, Sultan AM, Moneer A, Said R, AbuEleneen A, Abu Zeid M, Abdallah T and Abdel Wahab M performed the research; El Nakeeb A and Sultan AM analysed the data; El Nakeeb A and Abdallah T wrote the paper.
Correspondence to: Ayman El Nakeeb, MD, Associate Professor of general surgery, Gastroenterology surgical center, Mansoura University, Gehan street, Mansoura 35516, Egypt. elnakeebayman@yahoo.com
Telephone: +20-10-6752021 Fax: +20-50-2251543
Received: June 17, 2013 Revised: August 29, 2013 Accepted: September 3, 2013 Published online: November 7, 2013
Core Tip
Core tip: Traditionally, cirrhosis has been considered a contraindication to major gastrointestinal surgery. Hospital mortality rates have been reported to be 17.5 % to 38% for cirrhotic patients undergoing gastrointestinal surgery. Pancreaticoduodenectomy is associated with an increased risk of postoperative morbidity in patients with liver cirrhosis; therefore, it is recommended only in patients with Child A cirrhosis. Cirrhotic patients with portal hypertension were associated with poorer outcome than cirrhotic patients without portal hypertension. Patients with periampullary tumours and well-compensated chronic liver disease should be routinely considered for radical surgery at high volume centres with available expertise to manage liver cirrhosis.
