Incidence of Postoperative Complications Following Pancreatectomy for Pancreatic Cystic Lesions or Pancreatic Cancer

Authors

Eileen C Donovan
Laura R Prakash
Yi-Ju Chiang
Morgan L Bruno
Jessica E Maxwell
Naruhiko Ikoma
Ching-Wei D Tzeng
Matthew H G Katz
Jeffrey E Lee
Michael P Kim

Publication Date

2-1-2023

Journal

Journal of Gastrointestinal Surgery

Abstract

Background: In contrast to pancreatic ductal adenocarcinoma (PDAC), the risks of pancreatectomy for mucinous pancreatic cysts (MCs) are balanced against the putative goal of removing potentially malignant tumors. Despite undergoing similar operations, different rates of perioperative complications and morbidity between MC and PDAC patient populations may affect recommendations for resection. We therefore sought to compare the rates of postoperative complications between patients undergoing pancreatectomies for MCs or PDAC.

Methods: A prospectively maintained institutional database was used to identify patients who underwent surgical resection for MCs or PDAC from July 2011 to August 2019. Patient demographics, complications, and perioperative data were compared between groups.

Results: A total of 103 patients underwent surgical resection for MCs and 428 patients underwent resection for PDAC. Combined major 90-day postoperative complications were similar between MC and PDAC patients undergoing pancreaticoduodenectomy (PD, 32.5% vs. 20.0%, p = 0.068) or distal pancreatectomy (DP, 30.2% vs. 20.5%, p = 0.172). The most frequent complications were postoperative pancreatic fistula (POPF), abscess, and postoperative bleeding. The incidence of 90-day ISGPS Grade B/C POPF was higher in cyst patients undergoing PD (17.5% vs. 4.1%, p = 0.003) but not DP (25.4% vs. 20.5%, p = 0.473). No significant differences in operative time or length of stay between MCs and PDAC cohorts were observed.

Conclusions: POPFs occur more frequently and at higher grades in patients undergoing PD for MCs than for PDAC and should inform patient selection. Accordingly, the perioperative management of MC patients undergoing PD should emphasize POPF risk mitigation.

Keywords

Humans, Pancreatectomy, Incidence, Pancreatic Neoplasms, Pancreaticoduodenectomy, Postoperative Complications, Carcinoma, Pancreatic Ductal, Pancreatic Fistula, Pancreatic Cyst, Retrospective Studies

DOI

10.1007/s11605-022-05534-3

PMID

36443557

PMCID

PMC11921787

PubMedCentral® Posted Date

3-19-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes