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Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers:A Nationwide Audit Study
- Source :
- de Bakker , J K , Suurmeijer , J A , the Dutch Pancreatic Cancer Group , Toennaer , J G J , Bonsing , B A , Busch , O R , van Eijck , C H , de Hingh , I H , de Meijer , V E , Molenaar , I Q , van Santvoort , H C , Stommel , M W , Festen , S , van der Harst , E , Patijn , G , Lips , D J , Den Dulk , M , Bosscha , K , Besselink , M G & Kazemier , G 2023 , ' Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers : A Nationwide Audit Study ' , Annals of Surgical Oncology , vol. 30 , no. 4 , pp. 2448-2455 .
- Publication Year :
- 2023
-
Abstract
- Background: Surgical outcome after pancreatoduodenectomy for duodenal adenocarcinoma could differ from pancreatoduodenectomy for other cancers, but large multicenter series are lacking. This study aimed to determine surgical outcome in patients after pancreatoduodenectomy for duodenal adenocarcinoma, compared with other periampullary cancers, in a nationwide multicenter cohort. Methods: After pancreatoduodenectomy for cancer between 2014 and 2019, consecutive patients were included from the nationwide, mandatory Dutch Pancreatic Cancer Audit. Patients were stratified by diagnosis. Baseline, treatment characteristics, and postoperative outcome were compared between groups. The association between diagnosis and major complications (Clavien–Dindo grade III or higher) was assessed via multivariable regression analysis. Results: Overall, 3113 patients, after pancreatoduodenectomy for cancer, were included in this study: 264 (8.5%) patients with duodenal adenocarcinomas and 2849 (91.5%) with other cancers. After pancreatoduodenectomy for duodenal adenocarcinoma, patients had higher rates of major complications (42.8% vs. 28.6%; p < 0.001), postoperative pancreatic fistula (International Study Group of Pancreatic Surgery [ISGPS] grade B/C; 23.1% vs. 13.4%; p < 0.001), complication-related intensive care admission (14.3% vs. 10.3%; p = 0.046), re-interventions (39.8% vs. 26.6%; p < 0.001), in-hospital mortality (5.7% vs. 3.1%; p = 0.025), and longer hospital stay (15 days vs. 11 days; p < 0.001) compared with pancreatoduodenectomy for other cancers. In multivariable analysis, duodenal adenocarcinoma was independently associated with major complications (odds ratio 1.14, 95% confidence interval 1.03–1.27; p = 0.011). Conclusion: Pancreatoduodenectomy for duodenal adenocarcinoma is associated with higher rates of major complications, pancreatic fistula, re-interventions, and in-hospital mortality compared with patients undergoing pancreatoduodenectomy for other
Details
- Database :
- OAIster
- Journal :
- de Bakker , J K , Suurmeijer , J A , the Dutch Pancreatic Cancer Group , Toennaer , J G J , Bonsing , B A , Busch , O R , van Eijck , C H , de Hingh , I H , de Meijer , V E , Molenaar , I Q , van Santvoort , H C , Stommel , M W , Festen , S , van der Harst , E , Patijn , G , Lips , D J , Den Dulk , M , Bosscha , K , Besselink , M G & Kazemier , G 2023 , ' Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers : A Nationwide Audit Study ' , Annals of Surgical Oncology , vol. 30 , no. 4 , pp. 2448-2455 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1376784490
- Document Type :
- Electronic Resource