RESUMEN
Background: The SARS-CoV-2 pandemic has caused a huge overload of the healthcare system worldwide. The Department of Gastroenterological Surgery and Transplantology of the Central Clinical Hospital of the Ministry of the Interior Affairs and Administration is a leading center in pancreatic oncology in Poland, where the largest number of pancreatic cancer surgeries is performed every year. Despite a significant reduction in the number of oncological beds in the period from March to December 2020 (9 beds, compared to 55 in 2019), a total of 116 surgeries were performed in the clinic in patients with pancreatic cancer. In the same period of 2019, from March to December, 180 such procedures were performed (26% more). Methods: Retrospective data analysis of medical documentation in the hospital database. Research covered he period of time from March-December 2019 and from March-December 2020. Results: The group of patients with pancreatic tumors who underwent surgical procedures form 1 Mar 2020 until 31 Dec 2020 consisted of 65 women and 51 men with a mean age 60.4 years (SD +/-13.2). 12.9% of operated patients had a history of type 2 diabetes. In our group of pts, 13 (8.8%) had a history of chronic pancreatitis. Average time of surgical procedure was 95,7 +/-36,4 minutes. The mean hospitalisation time was 12,5 +/-14,5 days. Characteristic of the 2020 study group: history of alcohol abuse (yes/ no) 4 (3.4%/96%);Tumor location: Head 56 (48.3%) Body 25 (21.5%) Tail 21 (18.1%);more than 1 location 14 (12.1 %);mean primary tumor size (cm) 3.5 +/- SD 2.2 cm;venous infiltration (yes/no) 40/76 (34% / 66%);lymph node invasion (yes/no) 59 / 57 (50.8% / 49.2%);splenectomy (yes / no) 40/76 (34% / 66%);neoadjuvant treatment (yes / no) 27/89 (23% / 77%). Type of procedures performed: Whipple surgery, 53 patients;Whipple surgery + vein reconstruction, 8 patients;Total pancreatectomy, 9 pts;Total pancreatectomy + venous reconstructions, 2;Distal pancreatic resection, 29 pts;distal pancreatic resection without spleen, 5;central pancreatic resection, 1;Frey surgery, 2;Bypass anastomosis, 5;liver metastases removal, 1;visceral nerve section, 1. In the group of 116 patients operated on for a pancreatic tumor in the “COVID-19 era”, only 6 people died, which resulted in a mortality of 5.2% Complications observed: bleeding into the peritoneal cavity, 1;shock, 2;gastrointestinal haemorrhage, 2;respiratory failure, 3;multi-organ failure, 1;pancreatic fistula, 1;lack of healing of pancreatic-intestinal anastomosis, 1;pneumonia, 5. None of the patients became infected with SARS-COV-2 during hospitalization. Conclusions: The relatively short time of hospitalisation was caused by the limited number of places in the clinic for COVID-negative patients and the necessity to quickly start up and transfer patients in good condition to other hospitals in the area. It seems that the low number of postoperative complications and low mortality are the result of a more precise selection of patients with pancreatic cancer before admission, as well as compliance with the principles of planning the procedure and the organization of the operating room work. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.