Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes : International Retrospective Multicenter Study
(2024) In Annals of Surgery 280(6). p.993-998- Abstract
OBJECTIVE: To develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure.
SUMMARY BACKGROUND DATA: Central pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to distal pancreatectomy but it is thought to increase the risk of short-term complications including postoperative pancreatic fistula (POPF).
METHODS: International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021). Primary endpoint was major... (More)
OBJECTIVE: To develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure.
SUMMARY BACKGROUND DATA: Central pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to distal pancreatectomy but it is thought to increase the risk of short-term complications including postoperative pancreatic fistula (POPF).
METHODS: International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021). Primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk model were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation.
RESULTS: 838 patients after CP were included (301 (36%) minimally invasive) and major morbidity occurred in 248 (30%) patients, POPF B/C in 365 (44%), and 30-day mortality in 4 (1%). Endocrine dysfunction in 91 patients (11%) and use of pancreatic enzymes in 108 (12%). The risk model for major morbidity included male sex, age, BMI, and ASA score≥3. The model performed acceptable with an area under curve (AUC) of 0.72(CI:0.68-0.76). The risk model for endocrine dysfunction included higher BMI and male sex and performed well (AUC:0.83 (CI:0.77-0.89)).
CONCLUSIONS: The proposed risk models help in tailoring the use of CP in patients with symptomatic benign and premalignant lesions in the body and neck of the pancreas and are readily available via www.pancreascalculator.com.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Surgery
- volume
- 280
- issue
- 6
- pages
- 993 - 998
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:85197191590
- pmid:38073561
- ISSN
- 1528-1140
- DOI
- 10.1097/SLA.0000000000006157
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
- id
- 607573f3-26c7-426d-9da2-5d6a7240404f
- date added to LUP
- 2024-09-30 13:04:47
- date last changed
- 2025-02-05 06:56:20
@article{607573f3-26c7-426d-9da2-5d6a7240404f,
abstract = {{<p>OBJECTIVE: To develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure.</p><p>SUMMARY BACKGROUND DATA: Central pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to distal pancreatectomy but it is thought to increase the risk of short-term complications including postoperative pancreatic fistula (POPF).</p><p>METHODS: International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021). Primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk model were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation.</p><p>RESULTS: 838 patients after CP were included (301 (36%) minimally invasive) and major morbidity occurred in 248 (30%) patients, POPF B/C in 365 (44%), and 30-day mortality in 4 (1%). Endocrine dysfunction in 91 patients (11%) and use of pancreatic enzymes in 108 (12%). The risk model for major morbidity included male sex, age, BMI, and ASA score≥3. The model performed acceptable with an area under curve (AUC) of 0.72(CI:0.68-0.76). The risk model for endocrine dysfunction included higher BMI and male sex and performed well (AUC:0.83 (CI:0.77-0.89)).</p><p>CONCLUSIONS: The proposed risk models help in tailoring the use of CP in patients with symptomatic benign and premalignant lesions in the body and neck of the pancreas and are readily available via www.pancreascalculator.com.</p>}},
author = {{van Bodegraven, Eduard Antonie and Lof, Sanne and Jones, Leia and Aussilhou, Béatrice and Yong, Gao and Jishu, Wei and Klotz, Rosa and Rocha-Castellanos, Dario Missael and Matsumato, Ippei and de Ponthaud, Charles and Tanaka, Kimitaka and Biesel, Esther and Kauffmann, Emmanuele and Dumitrascu, Traian and Nagakawa, Yuichi and Martí-Cruchaga, Pablo and Roeyen, Geert and Zerbi, Alessandro and Goetz, Mara and de Meijer, Vincent and Pessaux, Patrick and Ignatavicius, Povilas and Demir, Ihsan and Giuffrida, Mario and Tingstedt, Bobby and Marino, Marco Vito and Mastoridis, Sotiris and Brunner, Maximilian and Mora-Oliver, Isabel and Bortolato, Cecilia and Gulla, Aisté and Apers, Thomas and Hermand, Hélène and Mitsuka, Yusuke and Popescu, Irinel and Boggi, Ugo and Wittel, Uwe and Hirano, Satoshi and Gaujoux, Sébastien and Kamei, Keiko and Fernández-Del Castillo, Carlos and Hackert, Thilo and Kuirong, Jiang and Yi, Miao and Sauvanet, Alain and Besselink, Marc and Abu Hilal, Mohammad and Dokmak, Safi}},
issn = {{1528-1140}},
language = {{eng}},
number = {{6}},
pages = {{993--998}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Annals of Surgery}},
title = {{Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes : International Retrospective Multicenter Study}},
url = {{http://dx.doi.org/10.1097/SLA.0000000000006157}},
doi = {{10.1097/SLA.0000000000006157}},
volume = {{280}},
year = {{2024}},
}