Distal pancreatectomy with multivisceral resection: A retrospective multicenter study – Case series

Ramia, José Manuel; Río-Martín, Juan V. del; Blanco‐Fernández, Gerardo; Cantalejo-Díaz, Miguel; Rotellar, Fernando; Sabater-Ortí, Luis; Carabias-Hernández, A.; Manuel-Vázquez, Alba; Hernández-Rivera, Pedro J.; Jaén-Torrejimeno, Isabel; Esteban-Gordillo, Sara; Muñoz-Forner, Elena; Plaza, Roberto de la; Longoria-Dubocq, Texell; Armas-Conde, Noelia De; Pardo-Sánchez, Fernando; Garcés-Albir, Marina; Serradilla-Martín, Mario

doi:10.1016/j.ijsu.2020.08.024

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…6 In this regard, locally advanced tumors of the colon or pancreas may require concurrent colectomy at the time of pancreatoduodenectomy (PD + C) which may further increase postoperative complications. [7][8][9] In theory, the addition of colectomy during PD may synergistically increase perioperative complications due to the higher bacterial load of the colon compared to the upper gastrointestinal tract. 10,11 Despite the increased risk of complications when performing this procedure, it remains the only curative treatment modality for malignant lesions involving the pancreas and colon.…”

Section: Introductionmentioning

confidence: 99%

“…In the vast majority of cases, the intent of surgery is to achieve negative (R0) margins sometimes requiring extensive resections 6 . In this regard, locally advanced tumors of the colon or pancreas may require concurrent colectomy at the time of pancreatoduodenectomy (PD + C) which may further increase postoperative complications 7–9 . In theory, the addition of colectomy during PD may synergistically increase perioperative complications due to the higher bacterial load of the colon compared to the upper gastrointestinal tract 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Harris

Osborn

Bennett

et al. 2022

J Hepato Biliary Pancreat

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Background Pancreatoduodenectomy is a complex operation with considerable morbidity and mortality. Locally advanced tumors may require concurrent colectomy. We hypothesized that a concurrent colectomy increases the risk associated with pancreatoduodenectomy. Methods This retrospective review of the 2014–2019 pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program registry classified operations as pancreatoduodenectomy (PD) versus pancreatoduodenectomy/colectomy (PD+C). The two groups were compared with respect to demographics, comorbidities, disease characteristics, intraoperative variables, and postoperative outcomes. Main effect models were developed to examine the effect of concurrent colectomy on outcomes after adjusting for potential confounders. Results Of 24 421 pancreatoduodenectomies, 430 (1.8%) involved concurrent colectomy. PD + C patients had less comorbidities (obesity 19% vs. 27%, hypertension 43% vs. 53%, diabetes 20% vs. 26%) and were associated with malignant diagnosis (94% vs. 83%), vascular resection (28% vs. 18%), and longer operative time (median 6.9 vs. 6 h). On multivariable analysis, concurrent colectomy was independently associated with serious morbidity (adjusted odds ratio [OR] 2.62, 95% confidence interval [CI]: 1.94–3.54) but not mortality (OR 1.44 [0.63–3.31]). Conclusions Concurrent colectomy at the time of pancreatoduodenectomy significantly increased the odds of serious morbidity but did not affect mortality. This should be considered in operative planning, preoperative counseling, and sequencing of cancer‐directed treatments.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Harris

Osborn

Bennett

et al. 2022

J Hepato Biliary Pancreat

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“…Resection of other organs in addition to pancreatic resection was not common in our series, but one could argue that, as long as a radical treatment is feasible, it could be warranted, as demonstrated by one recent systemic review of a case of a pancreatic tumor and confirmed by other authors [30][31][32].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 78%

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Blanco‐Fernández

Fondevila-Campo

Sanjuánbenito

et al. 2022

European Journal of Surgical Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The analysis of the literature shows contrasting results. While several single-institution studies showed no increase in mortality with extended resection [ 19 , 21 , 22 , 23 ], a recent study reported higher 60-day mortality for patients undergoing extended DP compared to those undergoing a standard DP (4.8% vs. 0.8%), [ 24 ]. A study by Siripong et al [ 25 ] looking at morbidity in standard DP versus extended DP reported that the rates of surgical complications were almost 20% greater in extended than standard DP alone.…”

Section: Discussionmentioning

confidence: 99%

Extended Distal Pancreatectomy for Cancer of the Body and Tail of the Pancreas: Analysis of Early and Late Results

Sperti,

Serafini,

Friziero

et al. 2023

JCM

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Cancer of the body-tail of the pancreas often involves adjacent structures. Thus, surgical treatment may be extended to other organs or vessels in order to achieve radical resection. The aim of this study is to evaluate the safety and efficacy of extended distal pancreatectomy for ductal adenocarcinoma of the body and tail of the pancreas. Between January 2000 and December 2016, 101 patients underwent distal pancreatectomy (DP) for pancreatic cancer: 65 patients underwent standard-DP and 36 extended-DP, including the resection of the partial stomach (n = 12), adrenal gland (n = 7), liver (n = 7), colon (n = 8), celiac axis (n = 6), portal vein (n = 5), jejunum (n = 4) and kidney (n = 4). The two groups were compared in terms of their TNM classification, pathological grade, nodal status, state of resection margins, age, sex and levels of preoperative serum carbohydrate antigen 19-9 (CA 19.9). The morbidity and mortality were not statistically different in the two groups. The two groups disease-free and overall survival rates were significantly influenced by the tumor’s stage, nodal status, pathological features and resection margins. Survival was not influenced by the extent of the surgical resection. However, when patients were stratified according to the type of extended resection, survival was worse in the group of patients undergoing vascular resection. Multivariate analysis showed that the stage and resection margins are independent predictors of disease-free and overall survival. Extended distal pancreatectomy may be performed with acceptable morbidity and mortality rates. Survival is not significantly different after standard or extended resection. However, the rate of tumor recurrence is high, and long-term survival is a rare event, especially in those patients who undergo distal pancreatectomy associated with vascular resection.

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Distal pancreatectomy with multivisceral resection: A retrospective multicenter study – Case series

Cited by 11 publications

References 13 publications

Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Morbidity of colectomy during pancreatoduodenectomy: An analysis of the pancreas‐targeted American College of Surgeons National Surgical Quality Improvement Program Registry

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Extended Distal Pancreatectomy for Cancer of the Body and Tail of the Pancreas: Analysis of Early and Late Results

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