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)
Stoop, Thomas F ; Augustinus, Simone ; Björnsson, Bergthor ; Tingstedt, Bobby LU ; Andersson, Bodil LU
; Wolfgang, Christopher L
; Werner, Jens
; Johansen, Karin
; Stommel, Martijn W J
and Katz, Matthew H G
, et al.
(2024)
In Annals of Surgical Oncology
- Abstract
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... (More)
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.
(Less)
- author
- Stoop, Thomas F
; Augustinus, Simone
; Björnsson, Bergthor
; Tingstedt, Bobby
LU
; Andersson, Bodil
LU
; Wolfgang, Christopher L
; Werner, Jens
; Johansen, Karin
; Stommel, Martijn W J
and Katz, Matthew H G
, et al. (More)
- Stoop, Thomas F
; Augustinus, Simone
; Björnsson, Bergthor
; Tingstedt, Bobby
LU
; Andersson, Bodil
LU
; 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.H.
; Pitt, Henry A
and Del Chiaro, Marco
(Less)
- author collaboration
- organization
- publishing date
- 2024-08-09
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Annals of Surgical Oncology
- publisher
- Springer
- external identifiers
-
- scopus:85201271070
- pmid:39120839
- ISSN
- 1534-4681
- DOI
- 10.1245/s10434-024-15932-3
- language
- English
- LU publication?
- yes
- additional info
- © 2024. The Author(s).
- id
- 3f73d961-9340-4193-9137-a6f4a2cf87ac
- date added to LUP
- 2024-09-30 12:58:09
- date last changed
- 2024-10-02 14:17:45
@article{3f73d961-9340-4193-9137-a6f4a2cf87ac,
abstract = {{<p>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.</p><p>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.</p><p>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.</p><p>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.</p>}},
author = {{Stoop, Thomas F and Augustinus, Simone and Björnsson, Bergthor and Tingstedt, Bobby and Andersson, Bodil and Wolfgang, Christopher L and Werner, Jens and Johansen, Karin and Stommel, Martijn W J and Katz, Matthew H G and Ghadimi, Michael and House, Michael G and Ghorbani, Poya and Molenaar, I Quintus and de Wilde, Roeland F and Mieog, J Sven D and Keck, Tobias and Wellner, Ulrich F and Uhl, Waldemar and Besselink, Marc G.H. and Pitt, Henry A and Del Chiaro, Marco}},
issn = {{1534-4681}},
language = {{eng}},
month = {{08}},
publisher = {{Springer}},
series = {{Annals of Surgical Oncology}},
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)}},
url = {{http://dx.doi.org/10.1245/s10434-024-15932-3}},
doi = {{10.1245/s10434-024-15932-3}},
year = {{2024}},
}