| Autor: |
Núria Lluís, Mario Serradilla-Martín, Mar Achalandabaso, François Jehaes, Bobby V.M. Dasari, Sara Mambrilla-Herrero, Ernesto Sparrelid, Anita Balakrishnan, Frederik J.H. Hoogwater, Maria J. Amaral, Bodil Andersson, Frederik Berrevoet, Alexandre Doussot, Víctor López-López, Mohammedsuror Alsammani, Olivier Detry, Carlos Domingo-del Pozo, Nikolaos Machairas, Damján Pekli, Cándido F. Alcázar-López, Horacio Asbun, Bergthor Björnsson, Thalis Christophides, Alberto Díez-Caballero, David Francart, Colin B. Noel, Donzília Sousa-Silva, Enrique Toledo-Martínez, George N. Tzimas, Sheraz Yaqub, François Cauchy, Mikel Prieto-Calvo, Melroy A. D’Souza, Harry V.M. Spiers, Marius C. van den Heuvel, Ramón Charco, Mickaël Lesurtel, José M. Ramia |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
International Journal of Surgery. 109:760-771 |
| ISSN: |
1743-9191 |
| Popis: |
BACKGROUND/PURPOSE: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western countries. The main aim of this study was to characterize current surgical strategies and outcomes in the mainly European participating centers.METHODS: A multi-institutional retrospective series of patients with a diagnosis of IPNB undergoing surgery between 1 January 2010 and 31 December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association. The textbook outcome (TO) was defined as a non-prolonged length of hospital stay plus the absence of any Clavien-Dindo grade at least III complications, readmission, or mortality within 90 postoperative days.RESULTS: A total of 28 centers contributed 85 patients who underwent surgery for IPNB. The median age was 66 years (55-72), 49.4% were women, and 87.1% were Caucasian. Open surgery was performed in 72 patients (84.7%) and laparoscopic in 13 (15.3%). TO was achieved in 54.1% of patients, reaching 63.8% after liver resection and 32.0% after pancreas resection. Median overall survival was 5.72 years, with 5-year overall survival of 63% (95% CI: 50-82). Overall survival was better in patients with Charlson comorbidity score 4 or less versus more than 4 ( P =0.016), intrahepatic versus extrahepatic tumor ( P =0.027), single versus multiple tumors ( P =0.007), those who underwent hepatic versus pancreatic resection ( P =0.017), or achieved versus failed TO ( P =0.029). Multivariable Cox regression analysis showed that not achieving TO (HR: 4.20; 95% CI: 1.11-15.94; P =0.03) was an independent prognostic factor of poor overall survival.CONCLUSIONS: Patients undergoing liver resection for IPNB were more likely to achieve a TO outcome than those requiring a pancreatic resection. Comorbidity, tumor location, and tumor multiplicity influenced overall survival. TO was an independent prognostic factor of overall survival. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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