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Clinical Outcomes After Total Pancreatectomy: A Prospective Multicenter Pan-European Snapshot Study
AEJ. Latenstein, L. Scholten, HA. Al-Saffar, B. Björnsson, G. Butturini, G. Capretti, NA. Chatzizacharias, C. Dervenis, I. Frigerio, TK. Gallagher, S. Gasteiger, A. Halimi, KJ. Labori, G. Montagnini, L. Muñoz-Bellvis, G. Nappo, A. Nikov, E....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- délka pobytu MeSH
- elektivní chirurgické výkony * MeSH
- lidé MeSH
- pankreatektomie * MeSH
- pooperační komplikace epidemiologie MeSH
- prospektivní studie MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
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.
Department of Abdominal Surgery University Medical Centre Ljubljana Ljubljana Slovenia
Department of General and Digestive Surgery University Hospital of Guadalajara Guadalajara Spain
Department of General Surgery Medical School University of Cyprus Nicosia Cyprus
Department of Hepato Pancreato Biliary Surgery Oslo University Hospital Oslo Norway
Department of Hepatopancreatobiliary and Transplant surgery Hospital Vall d'Hebrón Barcelona Spain
Department of HPB and Transplant Surgery St Vincent's University Hospital Dublin Ireland
Department of Pathology Hospital Clínico Universitario ''Virgen de la Arrixaca '' Murcia Spain
Department of Surgery Central Military Hospital Prague Prague Czech Republic
Department of Surgery Hospital Cli ́nico Universitario ''Virgen de la Arrixaca ''Murcia Spain
Department of Surgery Koc University Istanbul Turkey
Department of Surgery Paracelsus Medical University Salzburg Austria
Department of Surgery Salzkammergut Klinikum Vöcklabruck Austria
Department of Surgery University of Salamanca HospitalUniversitario de Salamanca Salamanca Spain
HPB Unit Department of Upper GI diseases Karolinska University Hospital Stockholm Sweden
ISS Aragón Department of Surgery Miguel Servet University Hospital Zaragoza Spain
Pancreatic Surgical Unit Pederzoli Hospital Peschiera del Garda Verona Italy
Citace poskytuje Crossref.org
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- $a Latenstein, Anouk E J $u Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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- $a Clinical Outcomes After Total Pancreatectomy: A Prospective Multicenter Pan-European Snapshot Study / $c AEJ. Latenstein, L. Scholten, HA. Al-Saffar, B. Björnsson, G. Butturini, G. Capretti, NA. Chatzizacharias, C. Dervenis, I. Frigerio, TK. Gallagher, S. Gasteiger, A. Halimi, KJ. Labori, G. Montagnini, L. Muñoz-Bellvis, G. Nappo, A. Nikov, E. Pando, M. Pastena, JM. Peña-Moral, D. Radenkovic, KJ. Roberts, R. Salvia, F. Sanchez-Bueno, C. Scandavini, M. Serradilla-Martin, S. Stättner, A. Tomazic, M. Varga, H. Zavrtanik, A. Zerbi, M. Erkan, J. Kleeff, M. Lesurtel, MG. Besselink, JM. Ramia-Angel, Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA)
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- $a 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.
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