Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes: International Retrospective Multicenter Study.

Autor:	van Bodegraven EA; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.; Cancer Center Amsterdam, the Netherlands., Lof S; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.; Cancer Center Amsterdam, the Netherlands., Jones L; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Aussilhou B; Department of HPB surgery and liver transplantation, Hospital of Beaujon, Clichy, France., Yong G; The Pancreas Center of Nanjing Medical University, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China., Jishu W; The Pancreas Center of Nanjing Medical University, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China., Klotz R; Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany., Rocha-Castellanos DM; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Matsumato I; Department of Surgery, Kindai University Faculty of Medicine, Osaka-sayama, Japan., de Ponthaud C; Department of Digestive, Hepato-biliary-pancreatic and Liver Transplantation, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France., Tanaka K; Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine., Biesel E; Medical Center-University of Freiburg, Department of General and Visceral Surgery, Freiburg, Germany., Kauffmann E; Division of General and Transplant Surgery, University of Pisa, Pisa., Dumitrascu T; Center of General Surgery and Liver Transplant, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Nagakawa Y; Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University., Martí-Cruchaga P; Servicio de Cirugía General y del Aparato Digestivo, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain., Roeyen G; Department of HPB, Endocrine and Transplantation Surgery, Antwerp University Hospital, Belgium., Zerbi A; Pancreatic Surgery Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy., Goetz M; Department of General, Visceral and Thoracic Surgery, University Medical Center, Hamburg, Germany., de Meijer V; Department of Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands., Pessaux P; Department of viscerale et digestive surgery, Nouvel Hopital Civil, university hospital, Strasbourg Institut Hospitalo-Universitaire de Strasbourg., Ignatavicius P; Department of Surgery, Lithuanian University of Health Sciences., Demir I; Technical University of Munich, Germany., Giuffrida M; Parma University Hospital-General Surgery Unit., Tingstedt B; Department of Surgery, University Hospital of Skane Lund, Lund University., Marino MV; Department of Emergency and General Surgery, P. Giaccone, Hospital, University of Palermo, Italy., Mastoridis S; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS., Brunner M; Department of General and Visceral Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Germany., Mora-Oliver I; Biochemical Research Institute, INCLICA. Hospital Clinico Universitario Valencia, Spain., Bortolato C; Department of Surgery, Ospedale dell'Angelo, Venice, Italy., Gulla A; Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania., Apers T; Department of General and Hepatopancreatobiliary Surgery and Liver Transplantation, Ghent University Hospital, Ghent, Belgium., Hermand H; Department of HPB surgery and liver transplantation, Hospital of Beaujon, Clichy, France., Mitsuka Y; Department of Gastrointestinal and Pediatric Surgery Tokyo Medical University., Popescu I; Center of General Surgery and Liver Transplant, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa., Wittel U; Medical Center-University of Freiburg, Department of General and Visceral Surgery, Freiburg, Germany., Hirano S; Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine., Gaujoux S; Department of Digestive, Hepato-biliary-pancreatic and Liver Transplantation, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France., Kamei K; Department of Surgery, Kindai University Faculty of Medicine, Osaka-sayama, Japan., Fernández-Del Castillo C; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Hackert T; Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.; Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Germany., Kuirong J; The Pancreas Center of Nanjing Medical University, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China., Yi M; The Pancreas Center of Nanjing Medical University, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China., Sauvanet A; Department of HPB surgery and liver transplantation, Hospital of Beaujon, Clichy, France., Besselink M; Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.; Cancer Center Amsterdam, the Netherlands., Abu Hilal M; Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy., Dokmak S; Department of HPB surgery and liver transplantation, Hospital of Beaujon, Clichy, France.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Dec 11. Date of Electronic Publication: 2023 Dec 11.
DOI:	10.1097/SLA.0000000000006157
Abstrakt:	Objective: To develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure. Summary Background Data: Central pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to distal pancreatectomy but it is thought to increase the risk of short-term complications including postoperative pancreatic fistula (POPF). Methods: International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021). Primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk model were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation. Results: 838 patients after CP were included (301 (36%) minimally invasive) and major morbidity occurred in 248 (30%) patients, POPF B/C in 365 (44%), and 30-day mortality in 4 (1%). Endocrine dysfunction in 91 patients (11%) and use of pancreatic enzymes in 108 (12%). The risk model for major morbidity included male sex, age, BMI, and ASA score≥3. The model performed acceptable with an area under curve (AUC) of 0.72(CI:0.68-0.76). The risk model for endocrine dysfunction included higher BMI and male sex and performed well (AUC:0.83 (CI:0.77-0.89)). Conclusions: The proposed risk models help in tailoring the use of CP in patients with symptomatic benign and premalignant lesions in the body and neck of the pancreas and are readily available via www.pancreascalculator.com. Competing Interests: Conflict of interest: The authors did not have any conflicts of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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