Oncologic multivisceral resections involving the pancreas

Rebelo, Artur; Andersson, Bodil; Bandyopadhyay, Samik Kumar; Bereza-Carlson, Paulina; Berrevoet, Frederik; Björnsson, Bergthor; Bouwense, Stefan; Bösch, Florian; Büchler, Markus; Chatzizacharias, Nikolaos; Coubeau, Laurent; Crede, Marie; Don, Cristine B Pathirannehalage; Dries, Pieter; Felsenstein, Matthäus; Frigerio, Isabella; Giardino, Alessandro; Glowka, Tim; Hadesi, Parsa; Hartman, Vera; Johansen, Karin; Klein, Marie; Klose, Johannes; Knipper, Karl; Leonhardt, Carl-Stephan; Loos, Martin; Malinka, Thomas; Marchegiani, Giovanni; Månsson, Christopher; Pellegrini, Riccardo; Perri, Giampaolo; Poelsler, Lh; Roeyen, Geert; Rousek, Michael; Sancho, Pablo; Schild-Suhren, Stina; Schmidt, Thomas; Serrablo, Leyre; Serrablo, Alejandro; Smith, Andrew Malvern; Stavrou, Gregor A; Strobel, Oliver; Strobel, Alexandra; Tarantino, Ignazio; Urdzik, Jozef; Vilz, Tim; Vella, Roberta; Wennerblom, Johanna; Wyzlic, Patricia; Kleeff, Jörg

Oncologic multivisceral resections involving the pancreas

Mark

Rebelo, Artur ; Andersson, Bodil ^LU

; Bandyopadhyay, Samik Kumar ; Bereza-Carlson, Paulina ^LU

; Berrevoet, Frederik ; Björnsson, Bergthor ; Bouwense, Stefan ; Bösch, Florian ; Büchler, Markus and Chatzizacharias, Nikolaos , et al. (2025) In International journal of surgery (London, England)

Abstract

OBJECTIVE: To evaluate short-term outcomes and identify predictors of morbidity and mortality following multivisceral oncologic resections involving the pancreas.

SUMMARY BACKGROUND DATA: Multivisceral resections including the pancreas are required for locally advanced abdominal malignancies but are associated with considerable perioperative risk. While smaller series suggest acceptable outcomes in selected patients, large-scale international data are lacking to guide surgical decision-making and risk stratification.

METHODS: This was a retrospective cohort study of 1,283 patients from 31 international centers who underwent multivisceral oncologic resections involving the pancreas. Patient demographics, tumor... (More)

OBJECTIVE: To evaluate short-term outcomes and identify predictors of morbidity and mortality following multivisceral oncologic resections involving the pancreas.

SUMMARY BACKGROUND DATA: Multivisceral resections including the pancreas are required for locally advanced abdominal malignancies but are associated with considerable perioperative risk. While smaller series suggest acceptable outcomes in selected patients, large-scale international data are lacking to guide surgical decision-making and risk stratification.

METHODS: This was a retrospective cohort study of 1,283 patients from 31 international centers who underwent multivisceral oncologic resections involving the pancreas. Patient demographics, tumor characteristics, operative details, and 90-day postoperative outcomes were analyzed.

RESULTS: The cohort had a mean age of 64.7 years, and 54.7% were male. Distal pancreatectomy was the most frequent procedure (60.5%), and R0 resection was achieved in 60.9% of cases. Ninety-day mortality was 6.9%, highest in patients with gastric adenocarcinoma (16.7%). Major complications (Clavien-Dindo grade III-V) occurred in 34.4% of patients. Higher ASA classification and open surgical approach were independently associated with increased morbidity and mortality. Prolonged operative time was associated with morbidity only. Female gender and treatment at high-volume centers were protective. In patients with pancreatic tumors, resection involving the colon (OR 1.78, p<0.001), stomach (OR 1.33, p = 0.042), or three or more organs (OR 1.75, p = 0.006) significantly increased complication rates.

CONCLUSIONS: Multivisceral resections involving the pancreas are associated with relevant perioperative risk. Optimizing patient selection, favoring minimally invasive techniques when feasible in selected patients, and centralizing care to high-volume centers may help improve outcomes for these complex surgical procedures.

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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/a4ada48a-d329-4cb9-a0a0-316f7a554b4a

author

Rebelo, Artur ; Andersson, Bodil ^LU

; Bandyopadhyay, Samik Kumar ; Bereza-Carlson, Paulina ^LU

; Berrevoet, Frederik ; Björnsson, Bergthor ; Bouwense, Stefan ; Bösch, Florian ; Büchler, Markus and Chatzizacharias, Nikolaos , et al. (More)

Rebelo, Artur ; Andersson, Bodil ^LU

; Bandyopadhyay, Samik Kumar ; Bereza-Carlson, Paulina ^LU

; Berrevoet, Frederik ; Björnsson, Bergthor ; Bouwense, Stefan ; Bösch, Florian ; Büchler, Markus ; Chatzizacharias, Nikolaos ; Coubeau, Laurent ; Crede, Marie ; Don, Cristine B Pathirannehalage ; Dries, Pieter ; Felsenstein, Matthäus ; Frigerio, Isabella ; Giardino, Alessandro ; Glowka, Tim ; Hadesi, Parsa ; Hartman, Vera ; Johansen, Karin ; Klein, Marie ; Klose, Johannes ; Knipper, Karl ; Leonhardt, Carl-Stephan ; Loos, Martin ; Malinka, Thomas ; Marchegiani, Giovanni ; Månsson, Christopher ; Pellegrini, Riccardo ; Perri, Giampaolo ; Poelsler, Lh ; Roeyen, Geert ; Rousek, Michael ; Sancho, Pablo ; Schild-Suhren, Stina ; Schmidt, Thomas ; Serrablo, Leyre ; Serrablo, Alejandro ; Smith, Andrew Malvern ; Stavrou, Gregor A ; Strobel, Oliver ; Strobel, Alexandra ; Tarantino, Ignazio ; Urdzik, Jozef ; Vilz, Tim ; Vella, Roberta ; Wennerblom, Johanna ; Wyzlic, Patricia and Kleeff, Jörg (Less)

author collaboration

Multivisceral Pancreatic Resections Research Group- A Collaboration of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA)

organization

publishing date

2025-12-19

type

Contribution to journal

publication status

epub

subject

in

International journal of surgery (London, England)

publisher

Elsevier

external identifiers

pmid:41417981

ISSN

1743-9159

DOI

10.1097/JS9.0000000000003731

language

English

LU publication?

yes

additional info

id

a4ada48a-d329-4cb9-a0a0-316f7a554b4a

date added to LUP

2026-01-22 19:08:26

date last changed

2026-01-23 07:30:26

@article{a4ada48a-d329-4cb9-a0a0-316f7a554b4a,
  abstract     = {{<p>OBJECTIVE: To evaluate short-term outcomes and identify predictors of morbidity and mortality following multivisceral oncologic resections involving the pancreas.</p><p>SUMMARY BACKGROUND DATA: Multivisceral resections including the pancreas are required for locally advanced abdominal malignancies but are associated with considerable perioperative risk. While smaller series suggest acceptable outcomes in selected patients, large-scale international data are lacking to guide surgical decision-making and risk stratification.</p><p>METHODS: This was a retrospective cohort study of 1,283 patients from 31 international centers who underwent multivisceral oncologic resections involving the pancreas. Patient demographics, tumor characteristics, operative details, and 90-day postoperative outcomes were analyzed.</p><p>RESULTS: The cohort had a mean age of 64.7 years, and 54.7% were male. Distal pancreatectomy was the most frequent procedure (60.5%), and R0 resection was achieved in 60.9% of cases. Ninety-day mortality was 6.9%, highest in patients with gastric adenocarcinoma (16.7%). Major complications (Clavien-Dindo grade III-V) occurred in 34.4% of patients. Higher ASA classification and open surgical approach were independently associated with increased morbidity and mortality. Prolonged operative time was associated with morbidity only. Female gender and treatment at high-volume centers were protective. In patients with pancreatic tumors, resection involving the colon (OR 1.78, p&lt;0.001), stomach (OR 1.33, p = 0.042), or three or more organs (OR 1.75, p = 0.006) significantly increased complication rates.</p><p>CONCLUSIONS: Multivisceral resections involving the pancreas are associated with relevant perioperative risk. Optimizing patient selection, favoring minimally invasive techniques when feasible in selected patients, and centralizing care to high-volume centers may help improve outcomes for these complex surgical procedures.</p>}},
  author       = {{Rebelo, Artur and Andersson, Bodil and Bandyopadhyay, Samik Kumar and Bereza-Carlson, Paulina and Berrevoet, Frederik and Björnsson, Bergthor and Bouwense, Stefan and Bösch, Florian and Büchler, Markus and Chatzizacharias, Nikolaos and Coubeau, Laurent and Crede, Marie and Don, Cristine B Pathirannehalage and Dries, Pieter and Felsenstein, Matthäus and Frigerio, Isabella and Giardino, Alessandro and Glowka, Tim and Hadesi, Parsa and Hartman, Vera and Johansen, Karin and Klein, Marie and Klose, Johannes and Knipper, Karl and Leonhardt, Carl-Stephan and Loos, Martin and Malinka, Thomas and Marchegiani, Giovanni and Månsson, Christopher and Pellegrini, Riccardo and Perri, Giampaolo and Poelsler, Lh and Roeyen, Geert and Rousek, Michael and Sancho, Pablo and Schild-Suhren, Stina and Schmidt, Thomas and Serrablo, Leyre and Serrablo, Alejandro and Smith, Andrew Malvern and Stavrou, Gregor A and Strobel, Oliver and Strobel, Alexandra and Tarantino, Ignazio and Urdzik, Jozef and Vilz, Tim and Vella, Roberta and Wennerblom, Johanna and Wyzlic, Patricia and Kleeff, Jörg}},
  issn         = {{1743-9159}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{Elsevier}},
  series       = {{International journal of surgery (London, England)}},
  title        = {{Oncologic multivisceral resections involving the pancreas}},
  url          = {{http://dx.doi.org/10.1097/JS9.0000000000003731}},
  doi          = {{10.1097/JS9.0000000000003731}},
  year         = {{2025}},
}

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Oncologic multivisceral resections involving the pancreas