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Journal of Gastrointestinal Surgery

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01-06-2015 | Original Article

Morbidity and Mortality of Pancreaticoduodenectomy for Benign and Premalignant Pancreatic Neoplasms

Authors: Timothy E. Newhook, Damien J. LaPar, James M. Lindberg, Todd W. Bauer, Reid B. Adams, Victor M. Zaydfudim

Published in: Journal of Gastrointestinal Surgery | Issue 6/2015

Abstract

Objectives

Patients with benign neoplasms of the pancreas are selected for pancreaticoduodenectomy if there is concern for malignant transformation. This study compares outcomes after pancreaticoduodenectomy for patients with premalignant and malignant pancreatic neoplasms.

Study Design

This retrospective cohort study included all patients who underwent pancreaticoduodenectomy for histologically confirmed benign/premalignant pancreatic neoplasms and primary pancreatic malignancy reported to National Surgical Quality Improvement Program (NSQIP) from 2005 to 2011. Patient characteristics, intraoperative and postoperative morbidity and mortality were compared.

Results

A total of 6085 patients underwent pancreaticoduodenectomy: 744 (12.2 %) for benign/premalignant and 5341 (87.8 %) for malignant pancreatic neoplasms. Patients with benign/premalignant neoplasms were more commonly female, had lower American Society of Anesthesiologists (ASA) class, and were less likely to have major comorbidities (all p ≤ 0.003). After resection, patients with benign/premalignant neoplasms were more likely to develop organ space infection (13.4 vs. 8.5 %, p < 0.001) and sepsis (12.2 vs. 9.2 %, p = 0.009). Cardiovascular, pulmonary, renal, and other organ system complications (p = 0.12) as well as 30-day mortality (3.0 vs. 2.0 %, p = 0.128) did not differ.

Conclusions

Organ space infection and sepsis are more common after pancreaticoduodenectomy for benign/premalignant neoplasms. Planned improvements in NSQIP data capture should allow for better measurement of this morbidity. A carefully balanced risk and benefit discussion should precede resection in these patients.

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Title: Morbidity and Mortality of Pancreaticoduodenectomy for Benign and Premalignant Pancreatic Neoplasms
Authors: Timothy E. Newhook
Damien J. LaPar
James M. Lindberg
Todd W. Bauer
Reid B. Adams
Victor M. Zaydfudim
Publication date: 01-06-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 6/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2799-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Morbidity and Mortality of Pancreaticoduodenectomy for Benign and Premalignant Pancreatic Neoplasms

Abstract

Objectives

Study Design

Results

Conclusions

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Springer Medicine

Abstract

Objectives

Study Design

Results

Conclusions

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