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Clinical Outcomes After Total Pancreatectomy A Prospective Multicenter Pan-European Snapshot Study

Latenstein, Anouk E. J. (author)
Univ Amsterdam, Netherlands
Scholten, Lianne (author)
Univ Amsterdam, Netherlands
Al-Saffar, Hasan Ahmad (author)
Karolinska Univ Hosp, Sweden
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Björnsson, Bergthor (author)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
Butturini, Giovanni (author)
Pederzoli Hosp, Italy
Capretti, Giovanni (author)
Humanitas Clin & Res Ctr IRCCS, Italy; Humanitas Univ Dept Biomed Sci, Italy
Chatzizacharias, Nikolaos A. (author)
Univ Hosp Birmingham NHS Trust, England
Dervenis, Chris (author)
Univ Cyprus, Cyprus
Frigerio, Isabella (author)
Pederzoli Hosp, Italy
Gallagher, Tom K. (author)
St Vincents Univ Hosp, Ireland
Gasteiger, Silvia (author)
Med Univ Innsbruck, Austria
Halimi, Asif (author)
Karolinska Univ Hosp, Sweden
Labori, Knut J. (author)
Oslo Univ Hosp, Norway
Montagnini, Greta (author)
Univ & Hosp Trust Verona, Italy
Munoz-Bellvis, Luis (author)
Univ Salamanca, Spain
Nappo, Gennaro (author)
Humanitas Clin & Res Ctr IRCCS, Italy; Humanitas Univ Dept Biomed Sci, Italy
Nikov, Andrej (author)
Cent Mil Hosp Prague, Czech Republic
Pando, Elizabeth (author)
Hosp Valle De Hebron, Spain
de Pastena, Matteo (author)
Univ & Hosp Trust Verona, Italy
De La Pena-Moral, Jesus M. (author)
Hosp Clin Univ Virgen Arrixaca, Spain
Radenkovic, Dejan (author)
Univ Belgrade, Serbia
Roberts, Keith J. (author)
Univ Hosp Birmingham NHS Trust, England
Salvia, Roberto (author)
Univ & Hosp Trust Verona, Italy
Sanchez-Bueno, Francisco (author)
Hosp Clin Univ Virgen Arrixaca, Spain
Scandavini, Chiara (author)
Karolinska Univ Hosp, Sweden
Serradilla-Martin, Mario (author)
Miguel Servet Univ Hosp, Spain
Stattner, Stefan (author)
Med Univ Innsbruck, Austria; Salzkammergut Klinikum, Austria
Tomazic, Ales (author)
Univ Med Ctr Ljubljana, Slovenia
Varga, Martin (author)
Paracelsus Med Univ, Austria
Zavrtanik, Hana (author)
Univ Med Ctr Ljubljana, Slovenia
Zerbi, Alessandro (author)
Humanitas Clin & Res Ctr IRCCS, Italy; Humanitas Univ Dept Biomed Sci, Italy
Erkan, Mert (author)
Koc Univ, Turkey
Kleeff, Jorg (author)
Martin Luther Univ Halle Wittenberg, Germany
Lesurtel, Mickael (author)
Univ Lyon 1, France
Besselink, Marc G. (author)
Univ Amsterdam, Netherlands
Ramia-Angel, Jose M. (author)
Univ Hosp Guadalajara, Spain
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 (creator_code:org_t)
LIPPINCOTT WILLIAMS & WILKINS, 2022
2022
English.
In: Annals of Surgery. - : LIPPINCOTT WILLIAMS & WILKINS. - 0003-4932 .- 1528-1140. ; 276:5, s. E536-E543
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Objective: To assess outcomes among patients undergoing total pancreatectomy (TP) including predictors for complications and in-hospital mortality. Background: Current studies on TP mostly originate from high-volume centers and span long time periods and therefore may not reflect daily practice. Methods: This prospective pan-European snapshot study included patients who underwent elective (primary or completion) TP in 43 centers in 16 European countries (June 2018-June 2019). Subgroup analysis included cutoff values for annual volume of pancreatoduodenectomies (<60 vs >= 60). Predictors for major complications and in-hospital mortality were assessed in multivariable logistic regression. Results: In total, 277 patients underwent TP, mostly for malignant disease (73%). Major postoperative complications occurred in 70 patients (25%). Median hospital stay was 12 days (IQR 9-18) and 40 patients were readmitted (15%). In-hospital mortality was 5% and 90-day mortality 8%. In the subgroup analysis, in-hospital mortality was lower in patients operated in centers with >= 60 pancreatoduodenectomies compared <60 (4% vs 10%, P = 0.046). In multivariable analysis, annual volume <60 pancreatoduodenectomies (OR 3.78, 95% CI 1.18-12.16, P = 0.026), age (OR 1.07, 95% CI 1.01-1.14, P = 0.046), and estimated blood loss >= 2L (OR 11.89, 95% CI 2.64-53.61, P = 0.001) were associated with in-hospital mortality. ASA >= 3 (OR 2.87, 95% CI 1.56-5.26, P = 0.001) and estimated blood loss >= 2L (OR 3.52, 95% CI 1.25-9.90, P = 0.017) were associated with major complications. Conclusion: This pan-European prospective snapshot study found a 5% inhospital mortality after TP. The identified predictors for mortality, including low-volume centers, age, and increased blood loss, may be used to improve outcomes.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

clinical outcomes; in-hospital mortality; snapshot study; total pancreatectomy

Publication and Content Type

ref (subject category)
art (subject category)

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