Copyright
©The Author(s) 2016.
World J Gastrointest Surg. Sep 27, 2016; 8(9): 634-642
Published online Sep 27, 2016. doi: 10.4240/wjgs.v8.i9.634
Published online Sep 27, 2016. doi: 10.4240/wjgs.v8.i9.634
Table 1 Demographics for 103 patients undergoing total pancreatectomy with subgroup analysis
Variable | Overall (n = 103) | PDAC (n = 42) | IPMN (n = 40) | LTP (n = 24) |
Age, yr1 | 70.2 (32-84.5) | 70.3 (33.3-84.5) | 71.3 (42.9-81.1) | 70.3 (37.3-84.5) |
Body mass index1 | 25.1 (17.7-42.1) | 24.2 (17.7-39.8) | 25.8 (18.5-42.1) | 26.7 (17.7-36.3) |
Male | 44 (42.7%) | 18 (42.9%) | 19 (47.5%) | 13 (54.2%) |
Hypertension | 70 (68%) | 29 (69%) | 31 (77.5%) | 14 (58.3%) |
Diabetes | 46 (44.7%) | 19 (45.2%) | 16 (40%) | 13 (54.2%) |
Cardiac disease | 31 (30.1%) | 8 (19%) | 14 (35%) | 7 (29.2%) |
Pulmonary disease | 19 (18.4%) | 7 (16.7%) | 7 (17.5%) | 5 (20.8%) |
ASA | ||||
II | 24 (23.3%) | 11 (26.2%) | 9 (22.5%) | 2 (8.3%) |
III | 72 (69.9%) | 26 (61.9%) | 29 (72.5%) | 22 (91.7%) |
IV | 7 (6.8%) | 5 (11.9%) | 2 (5%) | 0 |
Type of resection | ||||
Standard | 35 (34%) | 17 (40.5%) | 10 (25%) | 5 (20.8%) |
Pylorus preserving | 56 (54.4%) | 20 (47.6%) | 27 (67.5%) | 16 (66.7%) |
Completion | 12 (11.6%) | 5 (11.9%) | 3 (7.5%) | 3 (12.5%) |
Table 2 Operative variables for 103 patients undergoing total pancreatectomy with subgroup analysis
Variable | Overall (n = 103) | PDAC (n = 42) | IPMN (n = 40) | LTP (n = 24) |
Operative time (min)1 | 426 (165-930) | 390 (165-636) | 435 (240-930) | 534 (234-770) |
Estimated blood loss (mL)1 | 500 (50-18000) | 500 (50-7800) | 525 (50-18000) | 200 (50-600) |
Intraoperative pRBC transfusion (unit)1 | 1 (0%-40%) | 2 (0%-30%) | 1 (0%-40%) | 0 (0%-2%) |
Vein resection | 18 (17.5%) | 13 (40%) | 4 (10%) | 1 (4.2%) |
Table 3 Postoperative outcomes and complications (90 d) for 103 patients undergoing total pancreatectomy
Variable | Overall (n = 103) | PDAC (n = 42) | IPMN (n = 40) | LTP (n = 24) |
Cardiac | 10 (9.7%) | 5 (11.9%) | 3 (7.5%) | 1 (4.2%) |
Pulmonary | 15 (14.6%) | 7 (16.7%) | 6 (15%) | 5 (20.8%) |
Renal insufficiency | 8 (7.8%) | 3 (7.1%) | 6 (15%) | 4 (16.7%) |
Hepatic insufficiency | 3 (2.4%) | 1 (2.4%) | 3 (7.5%) | 2 (8.3%) |
Major glycemic event | 6 (5.8%) | 3 (7.1%) | 2 (5%) | 1 (4.2%) |
Post-pancreatectomy hemorrhage | 5 (4.9%) | 0 (0.0%) | 4 (10%) | 4 (16.7%) |
A | 2 (1.9%) | 0 | 2 (5%) | 2 (8.3%) |
B | 1 (0.8%) | 0 | 0 | 1 (4.2%) |
C | 2 (1.9%) | 0 | 2 (5%) | 1 (4.2%) |
Delayed gastric emptying | 14 (13.6%) | 5 (11.9%) | 5 (12.5%) | 2 (8.3%) |
A | 4 (4.9%) | 2 (4.8%) | 2 (5%) | 0 |
B | 5 (4.9%) | 2 (4.8%) | 1 (2.5%) | 1 (4.2%) |
C | 5 (4.9%) | 1 (2.4%) | 2 (5%) | 1 (4.2%) |
Wound infection | 11 (10.7%) | 5 (11.9%) | 2 (5%) | 2 (8.3%) |
Intra-abdominal abscess | 14 (13.6%) | 2 (4.8%) | 8 (20%) | 4 (16.7%) |
Biliary fistula | 2 (1.9%) | 0 | 1 (2.5%) | 0 |
Mesenteric/portal vein thrombosis | 5 (4.9%) | 2 (4.8%) | 2 (5%) | 1 (4.2%) |
Reoperation | 7 (6.8%) | 2 (4.8%) | 2 (5%) | 2 (8.3%) |
Patients intensive care stay | 64 (62.1%) | 24 (57.1%) | 30 (75%) | 10 (41.7%) |
Median intensive care stay, d1 (range) | 2 (1-59) | 2 (1-12) | 2 (1-59) | 2 (1-33) |
Overall morbidity | 66 (64.1%) | 27 (64.3%) | 25 (62.5%) | 10 (41.7%) |
Major (III-V) | 33 (32%) | 13 (31%) | 13 (32.5%) | 5 (20.8%) |
IIIa | 14 (13.6%) | 5 (11.9%) | 6 (15%) | 0 |
IIIb | 3 (2.9%) | 2 (4.8%) | 0 | 0 |
IVa | 4 (4.9%) | 1 (2.4%) | 2 (5%) | 2 (8.3%) |
IVb | 5 (4.9%) | 2 (4.8%) | 1 (2.5%) | 2 (8.3%) |
V | 7 (6.8%) | 3 (7.1%) | 4 (10%) | 1 (4.2%) |
Length of stay, d1 (range) | 9 (3%-71%) | 9 (3%-71%) | 10 (4%-67%) | 8 (4%-52%) |
Readmission | 26 (25.2%) | 12 (28.6%) | 8 (20%) | 3 (12.5%) |
Table 4 Pathologic findings for 103 patients undergoing total pancreatectomy
Variable | Overall (n = 103) | LTP (n = 24) |
Malignant | n = 53 | n = 12 |
Pancreatic ductal adenocarcinoma | 42 (40.8%) | 5 (20.8%) |
De novo | 23 (22.3%) | 3 (12.5%) |
Arising from IPMN | 19 (18.5%) | 2 (8.3%) |
Neuroendocrine | 7 (6.8%) | 6 (25%) |
Cholangiocarcinoma with IPMN | 1 (0.97%) | 0 |
Ampullary adenocarcinoma with IPMN | 1 (0.97%) | 1 (4.2%) |
Renal cell carcinoma | 1 (0.97%) | 0 |
Sarcoma | 1 (0.97%) | 0 |
Tumor size, cm1 | 3.5 ± 2.4 (0.5%-14%) | 3.2 ± 2.5 (1.3%-10%) |
Margin negative (R0) | 41 (77.4%) | 11 (91.7%) |
Number of lymph nodes harvested1 | 23 ± 14 (1%-61%) | 28 ± 11 (11%-41%) |
Non malignant | n = 50 | n = 12 |
IPMN | 40 (38.8%) | 11 (45.8%) |
Chronic pancreatitis | 8 (7.8%) | 1 (4.2%) |
Ampullary adenoma with IPMN | 1 (0.97%) | 0 |
Trauma | 1 (0.97%) | 0 |
- Citation: Zakaria HM, Stauffer JA, Raimondo M, Woodward TA, Wallace MB, Asbun HJ. Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center. World J Gastrointest Surg 2016; 8(9): 634-642
- URL: https://www.wjgnet.com/1948-9366/full/v8/i9/634.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v8.i9.634