| Title: |
Surgical Outcome After Distal Pancreatectomy With and Without Portomesenteric Venous Resection in Patients with Pancreatic Adenocarcinoma:A Transatlantic Evaluation of Patients in North America, Germany, Sweden, and The Netherlands (GAPASURG) |
| Authors: |
Stoop,Thomas F; Augustinus,Simone; Björnsson,Bergthor; Tingstedt,Bobby; Andersson,Bodil; Wolfgang,Christopher L; Werner,Jens; Johansen,Karin; Stommel,Martijn W J; Katz,Matthew H G; Ghadimi,Michael; House,Michael G; Ghorbani,Poya; Molenaar, I Quintus; de Wilde,Roeland F; Mieog,J Sven D; Keck,Tobias; Wellner,Ulrich F; Uhl,Waldemar; Besselink,Marc G; Pitt,Henry A; Del Chiaro,Marco; for the Global Audits on Pancreatic Surgery Group (GAPASURG); MS CGO; Cancer |
| Publication Year: |
2024 |
| Subject Terms: |
Distal pancreatectomy; Pancreatic cancer; Surgical outcome; Venous resection; Oncology; Surgery |
| Description: |
BACKGROUND: Pancreatic adenocarcinoma located in the pancreatic body might require a portomesenteric venous resection (PVR), but data regarding surgical risks after distal pancreatectomy (DP) with PVR are sparse. Insight into additional surgical risks of DP-PVR could support preoperative counseling and intraoperative decision making. This study aimed to provide insight into the surgical outcome of DP-PVR, including its potential risk elevation over standard DP. METHODS: We conducted a retrospective, multicenter study including all patients with pancreatic adenocarcinoma who underwent DP ± PVR (2018-2020), registered in four audits for pancreatic surgery from North America, Germany, Sweden, and The Netherlands. Patients who underwent concomitant arterial and/or multivisceral resection(s) were excluded. Predictors for in-hospital/30-day major morbidity and mortality were investigated by logistic regression, correcting for each audit. RESULTS: Overall, 2924 patients after DP were included, of whom 241 patients (8.2%) underwent DP-PVR. Rates of major morbidity (24% vs. 18%; p = 0.024) and post-pancreatectomy hemorrhage grade B/C (10% vs. 3%; p = 0.041) were higher after DP-PVR compared with standard DP. Mortality after DP-PVR and standard DP did not differ significantly (2% vs. 1%; p = 0.542). Predictors for major morbidity were PVR (odds ratio [OR] 1.500, 95% confidence interval [CI] 1.086-2.071) and conversion from minimally invasive to open surgery (OR 1.420, 95% CI 1.032-1.970). Predictors for mortality were higher age (OR 1.087, 95% CI 1.045-1.132), chronic obstructive pulmonary disease (OR 4.167, 95% CI 1.852-9.374), and conversion from minimally invasive to open surgery (OR 2.919, 95% CI 1.197-7.118), whereas concomitant PVR was not associated with mortality. CONCLUSIONS: PVR during DP for pancreatic adenocarcinoma in the pancreatic body is associated with increased morbidity, but can be performed safely in terms of mortality. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text/plain |
| Language: |
English |
| ISSN: |
1068-9265 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/458175 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/458175 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.AF4C382 |
| Database: |
BASE |