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

Author

Latenstein, Anouk E.J., Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A., Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K., Gasteiger, Silvia, Halimi, Asif, Labori, Knut J., Montagnini, Greta, Muñoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, Pastena, Matteo de, Peña-Moral, Jesús M. de la, Radenkovic, Dejan, Roberts, Keith J., Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stättner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jörg, Lesurtel, Mickaël, Besselink, Marc G., and Ramia-Angel, Jose M.

Published
2022
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5. Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

Author

Knoph, Cecilie Siggaard, Lucocq, James, Kamarajah, Sivesh Kathir, Olesen, Søren Schou, Jones, Michael, Samanta, Jayanta, Talukdar, Rupjyoti, Capurso, Gabriele, de‐Madaria, Enrique, Yadav, Dhiraj, Siriwardena, Ajith K., Windsor, John, Drewes, Asbjørn Mohr, Nayar, Manu, Cark, Neil, Pius, Riinu, Houghton, Eduardo, Gimenéz, Mariano, Uribe, Karla, Rodriguez, Florencia, Gundara, Justin, Mackay, Thomas, Phan, Huynh, Lewin, Joel, McElhatton, Claire, Siriwardhane, Mehan, Hodgson, Russell, Malik, Hassan, Ward, Ryan, Young, Kerilee, Bappayya, Shaneel, Loveday, Benjamin, Samra, Jaswinder, Gall, Tamara, Mittal, Anubhav, Chan, Ting Ting, Lo, Vincent Wing‐ho, Liang, Hui, Wang, Cong, Huang, Wei, Jin, Tao, Wu, Yongzi, Xia, Qing, Georgio, Nikolaou, Koronakis, Nikolaos, Davidsen, Line, Hamed, Emad, Mohamed, Salem, Demetrashvili, Zaza, Tvaladze, Ana, Kachakhidze, Irakli, Zurabashvili, Tea, Ioannidis, Orestis, Kapiris, Stylianos, Mavrodimitraki, Eleni, Sotiropoulou, Maria, Machairas, Nikolaos, Schizas, Dimitrios, Syllaios, Athanasios, Vailas, Michail, Chlorakis, Georgios, Kalaitzakis, Evangelos, Tsafaridou, Maria, Mulita, Francesk, Verras, Georgios‐Ioannis, Gupta, Amit, Rajput, Deepak, Sharma, Oshin, Goud, Rajesh, Unnisa, Misbah, Bains, Lovenish, Singh, Nishu, Dhar, Jahnvi, Abdelmoeti, Mahmoud, Súilleabháin, Criostóir Ó, O'Connell, Robert, Calabro, Marcello, La Terra, Antonio, Muretore, Andrea, Contul, Riccardo Brachet, Diotallevi, Margherita, Mascaro, Annamaria, Millo, Paolo, Biondo, Santino Antonio, Mazzeo, Carmelo, Cucinotta, Eugenio, Fleres, Francesco, Marinak, AOUG, Brocco, Veronica, Ceresoli, Marco, Rennis, Maria, Centonze, Danilo, Distefano, Coatanza, Veroux, Massimiliano, Zerbo, Domenico, Bogoni, Selene, Biloslavo, Alan, Bianchi, Velentina, Candelli, Marcello, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico, Sganga, Gabriele, Tropeano, Giuseppe, Policlinico, Fondazione, Altieri, Caterina, Dinuzzi, Vincenza, Marconi, Matteo, Rivolta, Umberto, Dameno, Vitale Roberto, Papa, Mario V., Balla, Andrea, Lepiane, Pasquale, Saraceno, Federica, Aiolfi, Alberto, Bona, Davide, Sozzi, Andrea, Cianci, Pasquale, Varesano, Marco, Conversano, Ivana, Abete, Roberta, D'Avino, Raffaele, Marra, Ester, Marte, Gianpaolo, Tammaro, Pasquale, Gobatti, Davide, Marmaggi, Serena, Palmieri, Francesco, Sampietro, Roberto, Manca, Roberto, Pilla, Federica, Piras, Enrico, Pignata, Giusto, Canfora, Ilaria, Andreuccetti, Jacopo, D'Alessio, Rossella, Armellin, Claudia, Grossi, Ugo, Massani, Marco, Pontin, Alessandro, Stecca, Tommaso, Pilia, Tiaizna, Pisanu, Adolfo, Podda, Mauro, Giuffrida, Mario, Perrone, Gennaro, Guadagni, Simone, Morelli, Luca, Frontali, Alice, Basurto, Francesca, D'Ugo, Stefano, Manoochehri, Farshad, Spampinato, Marcello, Apadula, Laura, Preatoni, Paoletta, Sartarelli, Lodovico, Al‐Jaiuossi, Osama, Ernisova, Mairam, Sopuev, Andrey, Sua, Bruce, Farfus, Anthony, Teo, Keith, Smith, Brittany, Ratnayake, Bathiya, Buchanan, Jayvee, Clark, Elinor, Connor, Saxon, Hore, Todd, Attari, Salman, Kadir, Bushra, Memon, Sadik, Abbas, Zaigham, Quadeer, Muhammad Ali, Altaf, Abeer, Ameet, Pooja, Devi, Jalpa, Seerani, Nandlal, Afzal, Ameer, Akbar, Ali, Asghar, Mohammad Sohail, Sa, Tiago, Barreira, Ana Lucia, Carvalho, Numo, Cismasiu, Brigitta, Henriques, Susana, Luiz, Francisco Vara, Draghici, Andreea, Grigorean, Valentin, Porojan, Vlad, Stoian, Alexandru‐Rares, Teaca, Lucia, Arbutina, Dragana, Cuk, Vladica, Kovacevic, Bojan, Mandic, Luka, Bonney, Glenn, Gao, Yujia, Pang, Ning Qi, Bellil, Abdalla, Devar, John, Khan, Zafar, Khumalo, Vusi, Smith, Martin, Estevez‐Fernandez, Sergio, Mosquera, Beatriz Romero, Rodriguez, Sergio, Garcia‐Rayado, Guillermo, Piñerua‐Gonsalvez, Jean Felix, Ruiz Rebollo, M Lourdes, Olmos, Jose M., Tejedor‐Tejada, Javier, Diez‐Alonso, Manuel, Matias‐Garcia, Belen, Moreno, Fernando Mendoza, Vera‐Mansilla, Cristina, Roses, Helena Salvador, Gómez, Diego Vázquez, Oballe, Juan Rodriguez, Jayarajah, Umesh, Nandasena, Malith, Pathirana, Aloka, Galal‐Eldin, Sami, Hajibandeh, Shahab, Hamid, Hytham, Colak, Elif, Sydorchuk, Larysa, Knut, Ruslan, Voronyuk, Ksenia, Chooklin, Serge, Baryskyi, Vitalii, Sydorchuk, Ruslan, Mukherjee, Samrat, Patel, Maitreyi, Akhtar, Amina, Asarbakhsh, Miriam, Nolan, Frances, Schuijtvlot, Nicholaas, Prem, Sandhya, Thrikandiyur, Anuradha, Morris, Millicent, Mroczek, Thomas, Sgourakis, George, Sultana, Asma, Varley, Rebecca, Groot‐Wassink, Thomas, Labinoti, Roland, Packham, Brett, Seebah, Keving, Allen, Sophie, Mokhtassi, Shiva, Belgaumkar, Ajay, De'Ath, Henry, Cook, Amy, Delaney, Christopher, Johnson, Roisin, Azibaodinami, Becky Olali, Sartini, Ashley, Stanfield, Mea, Tomasi, Ivan, Kanakala, Venkat, Mbarushimana, Simon, McKeever, Mark, Batilli, Mamata, Bhatta, Gakul, Rai, Subash, Bond‐smith, Giles, Elserafy, Amr, Shams, Mohamed, Al Saoudi, Tareq, Bhardwaj, Neil, Hussain, Wajith, Lancellotti, Francesco, Montagnini, Greta, Cairns, George, Hollyman, Marianne, Rakin, Asef, Shahid, Mishal, Barbour, Fraser, Hawkyard, Jake, McTeer, Matthew, Pandanaboyana, Sanjay, Taylor, Ellie, Kuzman, Matta, Dyer, Sarah, Hopkins, James, Pournaras, Dimitri, Sudlow, Alexis, Kumar, SK, Aujayeb, Avinash, Leo, Alex, Senra, Fatima Lorenzana, Watfah, Josef, Barrie, Jenifer, Brown, Chris, Gomez, Dhanny, Aroori, Somaiah, Ciprani, Debora, Karmarkar, Rahi, Almomani, Eyas, Roberts, Keith, Fale, Madeleine, Gupta, Ajay, Marsden, Max, Seet, Chris, Soni, Lakshya, Hamdan, Mohammed, Sadera, Rohan, Sud, Vikas, Chinnah, Edith, Di Mauro, Davide, Manzelli, Antonio, Orabi, Amira, Presa, Roberto, Reece‐Smith, Alex, Wajed, Shahjehan, Fingret, Jacob, Shah, Nehal, Jatania, Jignesh, Krishna, Arun, Berry, David, Kitsikosta, Loukiani, Helliwell, Jack, Huntley, Benjamin, Pine, James, Yau, Jih‐Dar, Lee, Shiela, Mahawar, Kamal, Shetty, Neehar, Britton, Emily, Shaw, Alice, Laarhoven, Stijn, Gahunia, Sukhpreet, Ortega, Miguel Gargia, Lee, Adam, Ng, Cho Ee, El Kafsi, Jihene, Mason, John, Vithlani, Gauri, Benhmida, Rami, Gunell, James, Parmar, Chetan, Dorkeh, Da‐Costa, Elnagar, Mohamed, Lee, Jih Ian, Nessa, Ashrafun, Yeap, Zhu Hui, Hemadasa, Niroshini, Javed, Saria, Sami, Sharuk, Damaskos, Dimitrios, Healey, Andrew, Soupashi, Maria, Triantafyllou, Tania, Coats, Maria, Douglass, Benjamin, Hendry, Brid, Hussain, Yasmin, Javid, Zhara, Mantyla, Mia, Rajkumar, Khaman, Chin, Carven, Hajibandeh, Shahab, Kumar, Nagappan, Gerogiannis, Ioannis, Kapsampelis, Panagiotis, Gerge, Farid, Anderson, Gulsum, Dinh, Vu, Phillips, Anna, Yadav, Dhiraj, and Pandanaboyana, Sanjay

Abstract

Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1‐month follow‐up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p< 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p< 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre‐admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p< 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p= 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre‐admission pain duration, acute necrotic collections, and walled‐off necrosis also increased the likelihood of opioid prescription at discharge. There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.

Published
2024
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6. Clinical Outcomes after Total Pancreatectomy: A Prospective Multicenter Pan-European Snapshot Study

Author

Latenstein, Anouk E. J., Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A., Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K., Gasteiger, Silvia, Halimi, Asif, Labori, Knut J., Montagnini, Greta, Muñoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, de Pastena, Matteo, de la Peña-Moral, Jesús M., Radenkovic, Dejan, Roberts, Keith J., Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stättner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jörg, Lesurtel, Mickaël, Besselink, Marc G., and Ramia-Angel, Jose M.

Published
2020
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7. Clinical Outcomes After Total Pancreatectomy A Prospective Multicenter Pan-European Snapshot Study

Author

Latenstein, Anouk E. J., Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A., Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K., Gasteiger, Silvia, Halimi, Asif, Labori, Knut J., Montagnini, Greta, Munoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, de Pastena, Matteo, De La Pena-Moral, Jesus M., Radenkovic, Dejan, Roberts, Keith J., Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stattner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jorg, Lesurtel, Mickael, Besselink, Marc G., Ramia-Angel, Jose M., Latenstein, Anouk E. J., Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A., Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K., Gasteiger, Silvia, Halimi, Asif, Labori, Knut J., Montagnini, Greta, Munoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, de Pastena, Matteo, De La Pena-Moral, Jesus M., Radenkovic, Dejan, Roberts, Keith J., Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stattner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jorg, Lesurtel, Mickael, Besselink, Marc G., and Ramia-Angel, Jose M.

Abstract

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.

Published
2022
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9. Assessment of difficulty in laparoscopic distal pancreatectomy: A modification of the Japanese difficulty scoring system – A single‐center high‐volume experience

Author

Deiro, Giacomo, primary, De Pastena, Matteo, additional, Paiella, Salvatore, additional, Balduzzi, Alberto, additional, Montagnini, Greta, additional, Andreotti, Elena, additional, Casetti, Luca, additional, Landoni, Luca, additional, Salvia, Roberto, additional, and Esposito, Alessandro, additional

Published
2021
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10. Antibiotic Prophylaxis with Piperacillin–Tazobactam Reduces Post-Operative Infectious Complication after Pancreatic Surgery: An Interventional, Non-Randomized Study

Author

De Pastena, Matteo, primary, Paiella, Salvatore, additional, Azzini, Anna Maria, additional, Zaffagnini, Amina, additional, Scarlini, Luigi, additional, Montagnini, Greta, additional, Maruccio, Martina, additional, Filippini, Chiara, additional, Romeo, Francesco, additional, Mazzariol, Annarita, additional, Cascio, Giuliana Lo, additional, Bazaj, Alda, additional, Secchettin, Erica, additional, Bassi, Claudio, additional, and Salvia, Roberto, additional

Published
2021
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11. Dual-Tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT Scan and G1-G2 Nonfunctioning Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Evaluation of 124 Nonmetastatic Resected Cases

Author

Paiella, Salvatore, primary, Landoni, Luca, additional, Tebaldi, Sarah, additional, Zuffante, Michele, additional, Salgarello, Matteo, additional, Cingarlini, Sara, additional, D’Onofrio, Mirko, additional, Parisi, Alice, additional, Deiro, Giacomo, additional, Manfrin, Erminia, additional, Bianchi, Beatrice, additional, Montagnini, Greta, additional, Crinò, Stefano Francesco, additional, Bassi, Claudio, additional, and Salvia, Roberto, additional

Published
2021
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12. Cost-effectiveness and quality of life analysis of laparoscopic and robotic distal pancreatectomy: a propensity score-matched study

Author

De Pastena, Matteo, primary, Esposito, Alessandro, additional, Paiella, Salvatore, additional, Surci, Niccolò, additional, Montagnini, Greta, additional, Marchegiani, Giovanni, additional, Malleo, Giuseppe, additional, Secchettin, Erica, additional, Casetti, Luca, additional, Ricci, Claudio, additional, Landoni, Luca, additional, Bovo, Chiara, additional, Bassi, Claudio, additional, and Salvia, Roberto, additional

Published
2020
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13. Dual-Tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT Scan and G1-G2 Nonfunctioning Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Evaluation of 124 Nonmetastatic Resected Cases.

Author

Paiella, Salvatore, Landoni, Luca, Tebaldi, Sarah, Zuffante, Michele, Salgarello, Matteo, Cingarlini, Sara, D'Onofrio, Mirko, Parisi, Alice, Deiro, Giacomo, Manfrin, Erminia, Bianchi, Beatrice, Montagnini, Greta, Crinò, Stefano Francesco, Bassi, Claudio, and Salvia, Roberto

Subjects
NEUROENDOCRINE tumors, POSITRON emission tomography, RECEIVER operating characteristic curves, PANCREATIC tumors, COMPUTED tomography
Abstract

Introduction: The combined use of 68gallium (68Ga)-DOTA-peptides and 18fluorine-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans in the workup of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers' capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods: Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, nonmetastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results: The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females (50.8%/49.2%) and G1 and G2 tumors (49.2%/50.8%). The disease was detected in 122 (98.4%) and 64 (51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4 vs. 40.6%; p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, interquartile range [IQR] 21 vs. 26 mm, IQR 20; p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3 (IQR 4) and 2 (IQR 4), respectively (p = 0.029). At least 1 pathological predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (vs. 56.7%; p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/>20 mm). None of the 2 tracers predicted nodal metastasis. The receiver operating characteristic curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2% and specificity of 73.3% for differentiating G1 from G2 (AUC = 0.624, p = 0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic workup of PanNETs despite not being a game-changer for the management of PanNETs ≤20 mm. [ABSTRACT FROM AUTHOR]

Published
2022
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14. Clinical Outcomes after Total Pancreatectomy: A Prospective Multicenter Pan-European Snapshot Study.

Author

UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, Latenstein, Anouk E J, Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A, Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K, Gasteiger, Silvia, Halimi, Asif, Labori, Knut J, Montagnini, Greta, Muñoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, de Pastena, Matteo, de la Peña-Moral, Jesús M, Radenkovic, Dejan, Roberts, Keith J, Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stättner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jörg, Lesurtel, Mickaël, Besselink, Marc G, Ramia-Angel, Jose M, Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), Bertrand, Claude, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, Latenstein, Anouk E J, Scholten, Lianne, Al-Saffar, Hasan Ahmad, Björnsson, Bergthor, Butturini, Giovanni, Capretti, Giovanni, Chatzizacharias, Nikolaos A, Dervenis, Chris, Frigerio, Isabella, Gallagher, Tom K, Gasteiger, Silvia, Halimi, Asif, Labori, Knut J, Montagnini, Greta, Muñoz-Bellvis, Luis, Nappo, Gennaro, Nikov, Andrej, Pando, Elizabeth, de Pastena, Matteo, de la Peña-Moral, Jesús M, Radenkovic, Dejan, Roberts, Keith J, Salvia, Roberto, Sanchez-Bueno, Francisco, Scandavini, Chiara, Serradilla-Martin, Mario, Stättner, Stefan, Tomazic, Ales, Varga, Martin, Zavrtanik, Hana, Zerbi, Alessandro, Erkan, Mert, Kleeff, Jörg, Lesurtel, Mickaël, Besselink, Marc G, Ramia-Angel, Jose M, Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and Bertrand, Claude

Abstract

To assess outcomes among patients undergoing total pancreatectomy (TP) including predictors for complications and in-hospital mortality. Current studies on TP mostly originate from high-volume centers and span long time periods and therefore may not reflect daily practice. 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 cut-off values for annual volume of pancreatoduodenectomies (<60 vs. ≥60). Predictors for major complications and in-hospital mortality were assessed in multivariable logistic regression. 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. This pan-European prospective snapshot study found a 5% in-hospital after TP. The identified predictors for mortality, including low-volume centers, age, and increased blood loss, may be used to improve outcomes.

Published
2020

15. Are Cystic Pancreatic Neuroendocrine Tumors an Indolent Entity Results from a Single-Center Surgical Series

Author

Paiella, Salvatore, primary, Marchegiani, Giovanni, additional, Miotto, Marco, additional, Malpaga, Anna, additional, Impellizzeri, Harmony, additional, Montagnini, Greta, additional, Pollini, Tommaso, additional, Nessi, Chiara, additional, Butturini, Giovanni, additional, Capelli, Paola, additional, Posenato, Ilaria, additional, Scarpa, Aldo, additional, D'Onofrio, Mirko, additional, De Robertis, Riccardo, additional, Cingarlini, Sara, additional, Boninsegna, Letizia, additional, Bassi, Claudio, additional, Salvia, Roberto, additional, and Landoni, Luca, additional

Published
2017
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16. Are Cystic Pancreatic Neuroendocrine Tumors an Indolent Entity Results from a Single-Center Surgical Series.

Author

Paiella, Salvatore, Marchegiani, Giovanni, Miotto, Marco, Malpaga, Anna, Impellizzeri, Harmony, Montagnini, Greta, Pollini, Tommaso, Nessi, Chiara, Butturini, Giovanni, Capelli, Paola, Posenato, Ilaria, Scarpa, Aldo, D'Onofrio, Mirko, De Robertis, Riccardo, Cingarlini, Sara, Boninsegna, Letizia, Bassi, Claudio, Salvia, Roberto, and Landoni, Luca

Subjects
NEUROENDOCRINE tumors, TUMORS, DEMOGRAPHIC surveys, POSTOPERATIVE care, SURVIVAL analysis (Biometry)
Abstract

Introduction: Cystic pancreatic neuroendocrine tumors (CPanNETs) represent an uncommon variant of pancreatic neuroendocrine tumors (PanNETs). Due to their rarity, there is a lack of knowledge with regard to clinical features and postoperative outcome. Methods: The prospectively maintained surgical database of a high-volume institution was queried, and 46 resected CPanNETs were detected from 1988 to 2015. Clinical, demographic, and pathological features and survival outcomes of CPanNETs were described and matched with a population of 92 solid PanNETs (SPanNETs) for comparison. Results: CPanNETs accounted for 7.8% of the overall number of resected PanNETs (46/587). CPanNETs were mostly sporadic (n = 42, 91%) and nonfunctioning (39%). Two functioning CPanNETs were detected (4.3%), and they were 2 gastrinomas. The median tumor diameter was 30 mm (range 10-120). All tumors were well differentiated, with 38 (82.6%) G1 and 8 (17.4%) G2 tumors. Overall, no CPanNET showed a Ki-67 >5%. A correct preoperative diagnosis of a CPanNET was made in half of the cases. After a median follow-up of >70 months, the 5- and 10-year overall survival of resected CPanNETs was 93.8 and 62.5%, respectively, compared to 92.7 and 84.6% for SPanNETs (p > 0.05). The 5- and 10-year disease-free survival rates were 94.5 and 88.2% for CPanNETs and 81.8 and 78.9% for SPanNETs, respectively (p > 0.05). Conclusion: In the setting of a surgical cohort, CPanNETs are rare, nonfunctional, and well-differentiated neoplasms. After surgical resection, they share the excellent outcome of their well-differentiated solid counterparts for both survival and recurrence. [ABSTRACT FROM AUTHOR]

Published
2018
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