Multicentric study on total pancreatectomies

Cir Esp (Engl Ed). 2019 Aug-Sep;97(7):377-384. doi: 10.1016/j.ciresp.2019.04.004. Epub 2019 Jun 1.
[Article in English, Spanish]

Abstract

Introduction: Total pancreatectomy (TP) is an uncommon operation, with indications that have not been clearly defined and non-standardized postoperative results. We present a national multicentric study on TP and a comparison with the existing literature METHODS: A prospective observational study using data from the national registry of patients after pancreaticoduodenectomy and TP performed for any indication during the study period: January 1 to December 31, 2015 RESULTS: 1016 patients were included from 73 hospitals, 112 of whom had undergone TP. The percentage of TP from the total number of cases was 11%. The mean age was 63.5 years, and 57.2% were males. The most frequently suspected radiological diagnosis was pancreatic cancer (58/112 cases). The most common TP technique was "mesentery artery first" (43/112 cases). Venous resections were performed in 23 patients (20.5%). The percentage of postoperative complications within 90 days was 50%, but major complications (>IIIA) were only 20.7%. The overall 90-day mortality was 8% (9 patients). The average stay was 20.7 days. The 3most frequent definitive histological diagnoses were: adenocarcinoma of the pancreas, intraductal papillary mucinous neoplasm and chronic pancreatitis. The R0 rate was 67.8%.

Conclusions: This study shows that the morbidity and mortality results of TP in Spain are similar or superior to previous publications. More precise TP studies are necessary, focused on specific complications such as endocrine insufficiency.

Keywords: Cirugía; Pancreas; Pancreatectomía total; Páncreas; Review; Revisión; Surgery; Total pancreatectomy.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / surgery
  • Aged
  • Female
  • Humans
  • Male
  • Mesenteric Arteries / surgery
  • Middle Aged
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Intraductal Neoplasms / diagnostic imaging
  • Pancreatic Intraductal Neoplasms / epidemiology
  • Pancreatic Intraductal Neoplasms / surgery
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / surgery
  • Pancreatitis, Chronic / diagnostic imaging
  • Pancreatitis, Chronic / epidemiology
  • Pancreatitis, Chronic / surgery
  • Postoperative Complications / epidemiology
  • Registries
  • Spain / epidemiology