Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study

Casadei, Riccardo; Ricci, Claudio; Taffurelli, Giovanni; Guariniello, Anna; Gioia, Anthony Di; Marco, Mariacristina Di; Pagano, Nico; Serra, Carla; Calculli, Lucia; Santini, Donatella; Minni, Francesco

doi:10.1007/s11605-016-3201-4

Cited by 39 publications

(75 citation statements)

References 27 publications

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“…After a median follow‐up of 45 months, patients in both groups had similar functional and symptom scales and global health status. Overall QoL after total pancreatectomy was good, and showed no significant difference from that in patients who had a pancreatoduodenectomy, according to Casadei and colleagues. Diabetes impacted poorly on QoL in both groups, but the overall PAID20 score tended to favour pancreatoduodenectomy ( P = 0·081).…”

Section: Resultsmentioning

confidence: 93%

“…The endocrine‐related morbidity rate was 25·9 per cent (112 of 432 patients). Ten studies, including 299 patients, reported the number of prescribed insulin units per day (mean 27 units/day). Mean(s.d.)…”

Section: Resultsmentioning

confidence: 99%

“…QoL after total pancreatectomy for all indications was reported in seven studies, including 243 patients, using various validated questionnaires. The median weighted follow‐up in these studies was 28·6 (range 6·0–66·0) months.…”

Section: Resultsmentioning

confidence: 99%

“…The median weighted follow‐up in these studies was 28·6 (range 6·0–66·0) months. The following questionnaires were used: EORTC QLQ‐C30 (5 studies), EORTC QLQ after pancreatic resection (EORTC QLQ‐PAN26) (3 studies), Audit of Diabetes Dependent Quality of Life (ADD‐QoL) (1 study), Short Form 36 (SF‐36) (1 study), Problem Areas in Diabetes scale (PAID20) (1 study) and EQ‐5D‐5L (1 study).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies compared QoL after total pancreatectomy with that following pancreatoduodenectomy. Epelboym et al .…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of functional outcome and quality of life after total pancreatectomy

Scholten¹,

Stoop²,

Chiaro

et al. 2019

British Journal of Surgery

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BackgroundSurgeons have traditionally been reluctant to perform total pancreatectomy because of concerns for brittle diabetes and poor quality of life (QoL). Several recent studies have suggested that outcomes following total pancreatectomy have improved, but a systematic review is lacking.MethodsA systematic review was undertaken of studies reporting on outcomes after total pancreatectomy for all indications, except chronic pancreatitis. PubMed, EMBASE (Ovid), and Cochrane Library were searched (2005–2018). Endpoints included functional outcome and QoL.ResultsA total of 21 studies, including 1536 patients, fulfilled the eligibility criteria. During a median follow‐up of 20·8 (range 1·5–96·0) months, 18·6 per cent (45 of 242 patients) were readmitted for endocrine‐related morbidity, with associated mortality in 1·6 per cent (6 of 365 patients). No diabetes‐related mortality was reported in studies including only patients treated after 2005. Symptoms related to exocrine insufficiency were reported by 43·5 per cent (143 of 329 patients) during a median follow‐up of 15·9 (1·5–96·0) months. Overall QoL, reported by 102 patients with a median follow‐up of 28·6 (6·0–66·0) months, using the EORTC QLQ‐C30 questionnaire, showed a moderately reduced summary score of 76 per cent, compared with a general population score of 86 per cent (P = 0·004).ConclusionOverall QoL after total pancreatectomy is affected adversely, in particular by the considerable impact of diarrhoea that requires better treatment. There is also room for improvement in the management of diabetes after total pancreatectomy, particularly with regards to prevention of diabetes‐related morbidity.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Two studies compared QoL after total pancreatectomy with that following pancreatoduodenectomy. Epelboym et al .…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of functional outcome and quality of life after total pancreatectomy

Scholten¹,

Stoop²,

Chiaro

et al. 2019

British Journal of Surgery

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Effect of surgery on the survival of elderly patients with early stage pancreatic cancer: A propensity‐matched analysis

Xie

Lei

et al. 2022

Aging and Cancer

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Background and objectives Research about the effect of surgery in geriatric patients with early stage pancreatic ductal adenocarcinoma (PDAC) is limited, and it remains a subject of much debate. The purpose of this study was to evaluate the role of surgery on the survival of elderly patients with T1‐3N0M0 PDAC and to further investigate the prognosis of these patients undergoing different surgical methods. Methods Patients aged ≥65 with T1‐3N0M0 PDAC diagnosed in 2004–2016 were collected from the Surveillance, Epidemiology, and End Results database. The imbalance of baseline characteristics was reduced by propensity score matching. We used the log‐rank tests to evaluate overall survival (OS) and cancer‐specific survival (CSS) among different groups. Univariate and multivariate Cox regression analysis was utilized to explore prognostic factors in PDAC. Results In total, 6363 patients were enrolled. After matching, 1110 patients were paired. We found that surgery could provide better survival (p < 0.001). Moreover, compared with those who underwent partial resection or larger resection, patients who underwent local tumor destruction had poorer OS and CSS (p < 0.001). However, no statistically significant survival differences were shown between the partial resection group and the larger resection group (p < 0.001). Conclusion Surgical intervention could confer a survival benefit to elderly patients with early stage PDAC. Additionally, these patients could benefit from more radical operations, and radical operations with reasonable extents are advocated rather than too aggressive methods.

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Total Pancreatectomy

Bayram

Michalski

Kleeff

2021

Textbook of Pancreatic Cancer

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Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study

Abstract: From this study, it seems reasonable to suggest that total pancreatectomy can be considered as safe, feasible, and efficacious as PD and acceptable in terms of cost-effectiveness.

Cited by 39 publications

References 27 publications

Systematic review of functional outcome and quality of life after total pancreatectomy

Systematic review of functional outcome and quality of life after total pancreatectomy

Effect of surgery on the survival of elderly patients with early stage pancreatic cancer: A propensity‐matched analysis

Total Pancreatectomy

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