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

Van Bodegraven EA, Lof S, Jones L, Aussilhou B, Yong G, Jishu W, Klotz R, Rocha-Castellanos DM, Matsumato I, De Ponthaud C, Tanaka K, Biesel E, Kauffmann E, Dumitrascu T, Nagakawa Y, Martí-Cruchaga P, Roeyen G, Zerbi A, Goetz M, De Meijer VE, Pessaux P, Ignatavicius P, Demir IE, Giuffrida M, Tingstedt B, Marino MV, Mastoridis S, Brunner M, Mora-Oliver I, Bortolato C, Gulla A, Apers T, Hermand H, Mitsuka Y, Popescu I, Boggi U, Wittel U, Hirano S, Gaujoux S, Kamei K, Fernández-Del Castillo C, Hackert T, Kuirong J, Yi M, Sauvanet A, Besselink M, Abu Hilal M, Dokmak S, Joos M, Dongha L, Scatton O, Nakamura T, Chikhladze S, Napoli N, Zozaya G, Hartman V, Pagnanelli M, Izbicki JR, Meerdink M, Giannone F, Barauskas G, Friess H, Valle RD, Williamsson C, Soonawalla Z, Druta JP, Khatov I, Takeda Y, Giuliani G, Sánchez-Velázquez P, Souche R, Kerem M, Ielpo B, Mioeg S, Banerjee A, Falgueras L, Sergeant G, SuárezMuñoz MA, Serrablo A, Al-Shehari MM, Payá-Llorente C, Navez J, Arenas SP, Jorba R, Labori KJ, Pando-Rau E (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 280

Pages Range: 993-998

Journal Issue: 6

DOI: 10.1097/SLA.0000000000006157

Abstract

Objective: To develop a prediction model for major morbidity and endocrine dysfunction after central pancreatectomy (CP) which could help in tailoring the use of this procedure. Background: CP is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and premalignant tumors in the body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared with 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). The primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk models were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation. Results: A total of 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, Body Mass Index, and American Society of Anesthesiologists score ≥3. The model performed acceptably with an area under the curve of 0.72 (CI: 0.68-0.76). The risk model for endocrine dysfunction included higher Body Mass Index and male sex and performed well [area under the curve: 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.

Authors with CRIS profile

Involved external institutions

Nanjing Medical University / 南京医科大学 China (CN) Universitätsklinikum Heidelberg Germany (DE) Harvard University United States (USA) (US) Kindai University / 近畿大学 Japan (JP) Pitié-Salpêtrière University Hospital / Hôpital universitaire Pitié-Salpêtrière France (FR) Universitätsklinikum Freiburg Germany (DE) University of Pisa / Università di Pisa (UniPi) Italy (IT) Carol Davila University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie „Carol Davila” (UMF București) Romania (RO) Tokyo Medical University (TMU) / 東京医科大学 Japan (JP) Clínica Universidad de Navarra Spain (ES) Hospital Network Antwerp / Ziekenhuis Netwerk Antwerpen (ZNA) Belgium (BE) Humanitas Research Hospital / IRCCS Istituto Clinico Humanitas Italy (IT) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) University Medical Center Groningen (UMCG) / Universitair Medisch Centrum Groningen Netherlands (NL) Lithuanian University of Health Sciences / Lietuvos sveikatos mokslų universitetas (LSMU) Lithuania (LT) Technische Universität München (TUM) Germany (DE) Azienda Ospedaliero-Universitaria di Parma / Parma University Hospital Italy (IT) Skåne University Hospital / Skånes universitetssjukhus Sweden (SE) Università degli Studi di Palermo Italy (IT) Oxford University Hospitals NHS Foundation Trust United Kingdom (GB) Hospital Clínico Universitario de Valencia Spain (ES) Ospedale dell'Angelo Italy (IT) Vilnius University / Vilniaus universitetas Lithuania (LT) University Hospital Ghent Belgium (BE) Beaujon Hospital / Hôpital Beaujon France (FR) University of Amsterdam Netherlands (NL) Fondazione Poliambulanza Istituto Ospedaliero Italy (IT)

How to cite

APA:

Van Bodegraven, E.A., Lof, S., Jones, L., Aussilhou, B., Yong, G., Jishu, W.,... Pando-Rau, E. (2024). Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes: International Retrospective Multicenter Study. Annals of Surgery, 280(6), 993-998. https://doi.org/10.1097/SLA.0000000000006157

MLA:

Van Bodegraven, Eduard Antonie, et al. "Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes: International Retrospective Multicenter Study." Annals of Surgery 280.6 (2024): 993-998.

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