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01-05-2017 | ORIGINAL ARTICLE

Distal pancreatectomy associated with multivisceral resection: results from a single centre experience

Authors: Francesca Panzeri, Giovanni Marchegiani, Giuseppe Malleo, Anna Malpaga, Laura Maggino, Tiziana Marchese, Roberto Salvia, Claudio Bassi, Giovanni Butturini

Published in: Langenbeck's Archives of Surgery | Issue 3/2017

Abstract

Purpose

Tumors arising in the body/tail of the pancreas tend to be diagnosed at a more advanced stage, with a lower rate of resectability compared to disease of the head. Distal pancreatectomy (DP) associated to multivisceral resections (MVR) can represent a surgical option for selected patients with advanced tumors.

Methods

We retrospectively analyzed data of patients who underwent DP associated with MVR at our Institution over a 9-year period, and compared them to standard DP. MVR was defined as resection of at least one additional organ or vascular structure because of neoplastic involvement.

Results

Out of 508 DP, in 59 cases MVR was performed. The absolute incidence of complications was comparable between the two groups (69.5 % in MVR arm vs. 57.2 % in control arm, p = 0.072) but more patients in the study group had a Clavien-Dindo class ≥3 (18.6 vs. 9.8 %, p = 0.04). A longer operative time (291 ± 91 vs. 227 ± 67, p < 0.001), an increased need for intraoperative transfusions (21.4 vs. 3.3 %, p < 0.001) and a slightly longer hospitalization (9 [7–16] days vs. 8 [7–10]; p < 0.001) were observed in the MVR group.

In patients with ductal adenocarcinoma (n = 118), mortality was comparable between groups (p = 0.44) over a median follow up of 26 [16–41] months. In contrast, among patients with neuroendocrine neoplasms, mortality was higher in the study group (p = 0.002).

Conclusion

Multivisceral resection for cancer of body and tail of the pancreas is feasible in selected cases, with an acceptable surgical complication rate compared to standard procedures and a favorable long-term survival in ductal cancer.

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Title: Distal pancreatectomy associated with multivisceral resection: results from a single centre experience
Authors: Francesca Panzeri
Giovanni Marchegiani
Giuseppe Malleo
Anna Malpaga
Laura Maggino
Tiziana Marchese
Roberto Salvia
Claudio Bassi
Giovanni Butturini
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 3/2017
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-016-1514-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distal pancreatectomy associated with multivisceral resection: results from a single centre experience

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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