Risk Factors for Post-Pancreaticoduodenectomy Mortality: Identification and Mitigation

Victor P Gazivoda, Timothy J Kennedy Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USACorrespondence: Timothy J Kennedy, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, New Brunswick, NJ, 08901, USA, Email tk431@cinj.rutgers.eduAbstract: Historically, postoperative mortality rates were high after pancreaticoduodenectomy (PD), but in recent times those rates have improved, and Whipple procedures are safely performed. Multiple factors have contributed to the improvement of postoperative mortality rates after PD over time. Known risk factors leading to postoperative mortality after PD are based on patient factors, surgeon/hospital factors, and postoperative factors. These factors can be attributed to improvements in patient selection and optimization, operative techniques and regionalization to high volume centers, and better understanding and standardization of postoperative care and management of common complications. Further studies should investigate preoperative optimization using prehabilitation and explore early diagnosis of postoperative complications and interventions to prevent mortality after PD.Keywords: pancreaticoduodenectomy, mortality, risk assessment, operative volume, failure to rescue, PD, FTR