Pneumonia is associated with a high risk of mortality after pancreaticoduodenectomy

Background Pancreatectomy is associated with a high complication rate that varies between 40–60%. Although many specific complications have been extensively studied, postoperative pneumonia has received little attention. Methods Patients undergoing pancreaticoduodenectomy ( n = 1,090) and distal pancreatectomy ( n = 436) from 2002 to 2014 at Thomas Jefferson University Hospital were retrospectively assessed for postoperative pneumonia. Incidence, predictive factors, and outcomes were determined. Results Pneumonia was diagnosed in 4.3% of patients after pancreaticoduodenectomy and 2.5% after distal pancreatectomy. The majority of the pneumonias were attributed to aspiration (87.2% and 81.8%, respectively). Pneumonias were more frequently severe (Clavien-Dindo grades 4 or 5) in the pancreaticoduodenectomy group compared to the distal pancreatectomy group (55.3% vs 9.1%, P = .006). Post-pancreaticoduodenectomy pneumonia predictors included delayed gastric emptying (odds ratio 8.2, P