| Title: |
Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple's (RAW) study |
| Authors: |
Russell, Thomas B.; Labib, Peter L.; Denson, Jemimah; Streeter, Adam; Ausania, Fabio; Pando, Elizabeth; Roberts, Keith J.; Kausar, Ambareen; Mavroeidis, Vasileios K.; Marangoni, Gabriele; Thomasset, Sarah C.; Frampton, Adam E.; Lykoudis, Pavlos; Maglione, Manuel; Alhaboob, Nassir; Bari, Hassaan; Smith, Andrew M.; Spalding, Duncan; Srinivasan, Parthi; Davidson, Brian R.; Bhogal, Ricky H.; Croagh, Daniel; Dominguez, Ismael; Thakkar, Rohan; Gomez, Dhanny; Silva, Michael A.; Lapolla, Pierfrancesco; Mingoli, Andrea; Porcu, Alberto; Shah, Nehal S.; Hamady, Zaed Z.R.; Al-Sarrieh, Bilal A.; Serrablo, Alejandro; Aroori, Somaiah |
| Publication Year: |
2023 |
| Collection: |
University of Southampton: e-Prints Soton |
| Description: |
Background: Pancreatoduodenectomy (PD) is associated with significant postoperative morbidity. Surgeons should have a sound understanding of the potential complications for consenting and benchmarking purposes. Furthermore, preoperative identification of high-risk patients can guide patient selection and potentially allow for targeted prehabilitation and/or individualized treatment regimens. Using a large multicentre cohort, this study aimed to calculate the incidence of all PD complications and identify risk factors. Method: Data were extracted from the Recurrence After Whipple’s (RAW) study, a retrospective cohort study of PD outcomes (29 centres from 8 countries, 2012–2015). The incidence and severity of all complications was recorded and potential risk factors for morbidity, major morbidity (Clavien–Dindo grade > IIIa), postoperative pancreatic fistula (POPF), post-pancreatectomy haemorrhage (PPH) and 90-day mortality were investigated. Results: Among the 1348 included patients, overall morbidity, major morbidity, POPF, PPH and perioperative death affected 53 per cent (n = 720), 17 per cent (n = 228), 8 per cent (n = 108), 6 per cent (n = 84) and 4 per cent (n = 53), respectively. Following multivariable tests, a high BMI (P = 0.007), an ASA grade > II (P < 0.0001) and a classic Whipple approach (P=0.005) were all associated with increased overall morbidity. In addition, ASA grade > II patients were at increased risk of major morbidity (P < 0.0001), and a raised BMI correlated with a greater risk of POPF (P=0.001). Conclusion: In this multicentre study of PD outcomes, an ASA grade > II was a risk factor for major morbidity and a high BMI was a risk factor for POPF. Patients who are preoperatively identified to be high risk may benefit from targeted prehabilitation or individualized treatment regimens. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://eprints.soton.ac.uk/485420/1/zrad106.pdf; RAW Study Collaborators (2023) Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple's (RAW) study. BJS Open, 7 (6), [zrad106]. (doi:10.1093/bjsopen/zrad106 ). |
| Availability: |
https://eprints.soton.ac.uk/485420/; https://eprints.soton.ac.uk/485420/1/zrad106.pdf |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.623FA6F1 |
| Database: |
BASE |