Contemporary Outcomes of Pancreatic Head Resection for Chronic Pancreatitis.

IF 7.5 1区医学 Q1 SURGERY

Annals of surgery Pub Date : 2025-03-21 DOI:10.1097/SLA.0000000000006700

Kyle A Lewellen, Thomas K Maatman, Andrew J Thyen, Meghan E Lark, James R Butler, Eugene P Ceppa, Michael G House, Attila Nakeeb, Alexandra M Roch, C Max Schmidt, Nicholas J Zyromski

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引用次数: 0

Abstract

Objective: To evaluate perioperative morbidity and mortality outcomes in a large, contemporary series of patients undergoing pancreas head resection for chronic pancreatitis.

Summary background data: Select chronic pancreatitis (CP) patients benefit from pancreatic head resection, but contemporary data are sparse. Anatomy dictates selection of duodenum-preserving pancreatic head resection (DPPHR) or pancreatoduodenectomy (PD). We hypothesized that both DPPHR and PD are safe in select patients.

Methods: CP patients undergoing pancreas head resection from 2007-2023 at a high-volume institution were analyzed. Patient comorbidities, operative data, and postoperative 30-day outcomes were defined according to National Surgical Quality Improvement Program (NSQIP) and International Study Group on Pancreatic Surgery (ISGPS). Preoperative and intraoperative variables between groups were compared. Continuous data are presented as median [interquartile range].

Results: Among 338 patients (50% female), 252 underwent PD and 86 DPPHR (69 Frey, 11 Beger, 4 Izbicki, 2 Bern). Median age was 52[17] years (PD 53.1[17], DPPHR 50.1[20], P=0.036). Preoperative tobacco use (57%) and diabetes (27%) were common. The PD group had longer operative times (282[131] vs. 207.5[91] minutes, P<0.001) and higher intraoperative blood loss (307.5[400] vs. 100[200] milliliters, P<0.001). Median length of stay was 8[6] days (PD 8[6.3], DPPHR 7[4]). Major morbidity occurred in 22% of patients (PD 23%, DPPHR 21%). At 30 days, the readmission rate was 17% (PD 17%, DPPHR 17%) and mortality occurred in 1.2% (PD 1.6%, DPPHR 0%).

Conclusions: This large, contemporary analysis demonstrated safety of pancreatic head resection in select CP patients.

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来源期刊

Annals of surgery 医学-外科

CiteScore

14.40

自引率

4.40%

发文量

687

审稿时长

4 months

期刊介绍： The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.