| Title: |
Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple’s (RAW) study |
| Authors: |
Russell, Thomas; Labib, Peter; Denson, Jemimah; Streeter, Adam; Ausania, Fabio; Pando, Elizabeth |
| Contributors: |
Institut Català de la Salut; Russell TB, Labib PL, Denson J Department of HPB Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK. Streeter Department of Medical Statistics, University of Muenster, Muenster, Germany. Department of Medical Statistics, University of Plymouth, Plymouth, UK. Ausania F Department of HPB Surgery, Hospital Clínic de Barcelona, Barcelona, Spain. Pando E Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d’Hebron Hospital Universitari, Barcelona, Spain; Vall d'Hebron Barcelona Hospital Campus |
| Source: |
Scientia |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2023 |
| Subject Terms: |
Pàncrees - Càncer - Cirurgia - Complicacions; Duodè - Càncer - Cirurgia - Complicacions; DISEASES::Pathological Conditions; Signs and Symptoms::Pathologic Processes::Postoperative Complications; ANALYTICAL; DIAGNOSTIC AND THERAPEUTIC TECHNIQUES; AND EQUIPMENT::Surgical Procedures; Operative::Digestive System Surgical Procedures::Pancreaticoduodenectomy; ENFERMEDADES::afecciones patológicas; signos y síntomas::procesos patológicos::complicaciones posoperatorias; TÉCNICAS Y EQUIPOS ANALÍTICOS; DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::pancreatoduodenectomía |
| Description: |
Postoperative complications; Pancreatoduodenectomy; Recurrence ; Complicaciones postoperatorias; Pancreatoduodenectomía; Recurrencia ; Complicacions postoperatòries; Pancreatoduodenectomia; Recurrència ; 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 ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
BJS Open;7(6); https://doi.org/10.1093/bjsopen/zrad106; Russell TB, Labib PL, Denson J, Streeter A, Ausania F, Pando E, et al. Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple’s (RAW) study. BJS Open. 2023 Dec;7(6):zrad106.; https://hdl.handle.net/11351/10846 |
| DOI: |
10.1093/bjsopen/zrad106 |
| Availability: |
https://hdl.handle.net/11351/10846; https://doi.org/10.1093/bjsopen/zrad106 |
| Rights: |
Attribution-NonCommercial 4.0 International ; http://creativecommons.org/licenses/by-nc/4.0/ ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.ECCE6D0 |
| Database: |
BASE |