Benchmarking Pancreaticoduodenectomy Outcomes in Peru: a 15-year Single-Institution Experience Using Global Quality Metrics

Reaño-Paredes G.; Kometter F.; Callacondo D.; Rego F.R.; Herrera-Chávez G.Á.; Hurtado W.L.; Uribe-León M.D.R.; Tang J.; Valer A.D.B.; Arenas Gamio J.L.; Apaza-Canaza M.A.; Ita S.A.; Bermúdez-Alfaro V.; Massucco Revoredo F.G.; Aliaga Í.L.; Fonseca Cavero L.D.P.; Carrasco F.; Alegre L.V.; Vinatea de Cárdenas J.D.; Polanco P.M. · HPB (2026) · DOI: 10.1016/j.hpb.2026.01.012

Resumen

Background: Reporting standards for pancreaticoduodenectomy (PD) in low- and middle-income countries remain uneven, and regional data continues to be scarce. In this study, we summarize 15 years of experience from a high-volume center in Peru using internationally recognized surgical quality metrics. Methods: We reviewed 414 PDs performed between 2009 and 2023. Outcomes were examined across three 5-year periods, using established definitions for morbidity, mortality, and key pancreatic complications. Composite indicators—Failure to Rescue (FTR) and Ideal Outcome (IO)—were also applied. Results: Overall morbidity was 54.1 %; major morbidity was 30.7 %, and in-hospital mortality was 4.8 %. Ninety-day mortality was 6.0 %, FTR 15.7 %, and IO 60.1 %, all without significant temporal changes. Clinically relevant POPF occurred at 22 %, decreasing early on and rising again during the pandemic period. Delayed gastric emptying occurred at 10.4 %, while PPH (8.5 %), readmission (5.8 %), reoperation (10.6 %), and length of stay (11 days) remained stable. Periampullary adenocarcinoma accounted for most indications (78 %), with ampullary tumors being the most frequent. Conclusions: This series—the largest contemporary Latin American report applying IO and FTR—shows outcomes comparable to international reference centers. These results were sustained despite increasing case complexity, the introduction of minimally invasive PD, and the disruptions caused by the COVID-19 pandemic.

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad Privada de Tacna