Pancreatic surgery and diagnosis of pancreatic cancer in North Karelia Central Hospital 2014–2019

Background Currently two hospitals performing pancreatic surgery in Finland have published their results. We compared results from our mid-sized central hospital to previously published benchmark data (n = 2375) from low risk patients (ASA 1–2).

Methods Perioperative data were prospectively collected to a database. Data from patients with ­
non-operable pancreatic region malignancy were imported from a separate endoscopic registry.

Results A total of 89 operations were done during the study period, 55 involving the pancreatic head. Altogether 66% of patients were ASA 3–4. Median follow-up time was 27.5 months. Complications occurred in 45% (vs 65%) of patients and 18% (vs 20%) were classified as serious. In-hospital mortality was 1.8% (vs 1.6%). One-year disease free survival for cancer patients was 55% (vs 42%, p < 0.001) and corresponding 3-year survival 25% (vs 0%, p < 0.001). Median lymph node yield (13 vs 18, p = 0.025) and number of R1 resections (42% vs 27%, p = 0.042) were under benchmark. During the years 2018–19 94% of stage I–II cancers were operated on. Median time from referral to operation was 21 days.

Conclusions It is possible to achieve similar results of diagnosis and treatment for operable pancreatic disease in a mid-sized hospital compared to high volume international centres.