Outcomes following pancreatic resections—results and challenges of an Austrian university hospital compared to nationwide data and international centres

Abstract

Background Despite clear advances in decreasing postoperative mortality below 4% after pancreatic resections in experienced centres, specific morbidity according to standardized definitions still remains high. While some recent multicentre studies have reported on complications after pancreatic surgery in Austria, detailed outcome data from single highvolume centres over longer time-periods are scarce. This study provides an in-depth picture of patient characteristics, indications, morbidity and mortality after pancreatic surgery in an Austrian tertiary referral centre. Methods All patients undergoing curative intent resection between 2010 and 2017 at the Medical University of Innsbruck were evaluated. Patient characteristics and procedural details, overall and specific complications including postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE) and postpancreatectomy haemorrhage (PPH) rates according to accepted definitions are reported. Outcomes after pancreatic head resections, distal pancreatectomy and other types of resections are compared. Factors associated with severe and overall morbidity are evaluated by logistic regression modelling. Results A total of 343 patients underwent pancreatic resection, at a median of 64 years (53% males). Most

Early Post‐Operative Pancreatitis and Systemic Inflammatory Response Assessed by Serum Lipase and IL‐6 Predict Pancreatic Fistula

“…To prevent future cardiac complications in our institution, preoperative work-up for major abdominal procedures now includes routine cardiac evaluation with cardio-pulmonary exercise testing and—if indicated—coronary artery angiography. Surgical complication related in-hospital mortality in this series was 2.8%, which is in line with that of other high-volume centres [ 1 , 2 ] and comparable to previously published data of our centre [ 3 ]. The high number of vascular reconstructions and concurrent other organ resections shows the progressive approach recently applied in our institution, potentially suggesting a need for optimization in patient selection as well as perioperative management.…”

Feasibility of robotic-assisted pancreatic resection in patients with previous minor abdominal surgeries: a single-center experience of the first three years

“…In the following, laparoscopy has also been introduced to the partial pancreaticoduodenectomy. Due to several limitations, laparoscopy is currently mostly limited to distal resections [ 10 , 16 ]. After its implementation, robotic assistance compensated for several disadvantages of laparoscopy: It provides a three-dimensional view and more sophisticated instrument manipulations, reduces tremor transmission, and allows for up to seven degrees of freedom.…”

The Role of Circulating MicroRNAs in Patients with Early-Stage Pancreatic Adenocarcinoma

“…Due to the absence of specific symptoms, the majority of patients with PDAC are diagnosed in the advanced stage, resulting in poor prognosis. Additionally, resection with curative intent is indicated only in a few of the cases, while surgery is associated with a high postoperative morbidity rate [3]. Disease relapses are also frequent, as PDAC has a high tendency of dissemination even at the early stage [4].…”