Distal pancreatectomy with celiac axis resection

What are the added risks?

Joal D. Beane, Michael G. House, Susan C. Pitt, E. Molly Kilbane, Bruce L. Hall, Abishek D. Parmar, Taylor S. Riall, Henry A. Pitt

    Research output: Contribution to journalArticle

    20 Citations (Scopus)

    Abstract

    Background Reported series of a distal pancreatectomy with celiac axis resection (DP-CAR) are either small or not adequately controlled. The aim of this analysis was to report a multicentre series of modified Appleby procedures with a comparison group to determine the relative operative risk. Methods Data were gathered through the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over 14 months, 822 patients underwent a distal pancreatectomy at 43 institutions. Twenty of these patients (2.4%) also underwent a celiac axis resection. DP-CAR patients were matched by age, gender, BMI, serum albumin, ASA class, gland texture, duct size and pathology to 172 patients undergoing DP alone. Results The majority of DP and DP-CAR patients had adenocarcinomas (61% and 60%). The median operative time for a DP alone was shorter than for a DP-CAR (207 versus 276 min, P < 0.01). Post-operative acute kidney injury (1% versus 10%, P < 0.03) and 30-day mortality were higher after a DP-CAR (1% versus 10%, P < 0.03). Conclusion A distal pancreatectomy with celiac axis resection is associated with increased operative time, post-operative acute kidney injury and a 10% operative mortality. The decision to offer a modified Appleby procedure for a body of pancreas tumour should be made with full disclosure of the increased risks.

    Original languageEnglish (US)
    Pages (from-to)777-784
    Number of pages8
    JournalHPB
    Volume17
    Issue number9
    DOIs
    StatePublished - Sep 1 2015

    Fingerprint

    Pancreatectomy
    Abdomen
    Operative Time
    Acute Kidney Injury
    Mortality
    Disclosure
    Quality Improvement
    Serum Albumin
    Pancreas
    Adenocarcinoma
    Pathology

    ASJC Scopus subject areas

    • Gastroenterology
    • Hepatology

    Cite this

    Beane, J. D., House, M. G., Pitt, S. C., Kilbane, E. M., Hall, B. L., Parmar, A. D., ... Pitt, H. A. (2015). Distal pancreatectomy with celiac axis resection: What are the added risks? HPB, 17(9), 777-784. https://doi.org/10.1111/hpb.12453

    Distal pancreatectomy with celiac axis resection : What are the added risks? / Beane, Joal D.; House, Michael G.; Pitt, Susan C.; Kilbane, E. Molly; Hall, Bruce L.; Parmar, Abishek D.; Riall, Taylor S.; Pitt, Henry A.

    In: HPB, Vol. 17, No. 9, 01.09.2015, p. 777-784.

    Research output: Contribution to journalArticle

    Beane, JD, House, MG, Pitt, SC, Kilbane, EM, Hall, BL, Parmar, AD, Riall, TS & Pitt, HA 2015, 'Distal pancreatectomy with celiac axis resection: What are the added risks?', HPB, vol. 17, no. 9, pp. 777-784. https://doi.org/10.1111/hpb.12453
    Beane JD, House MG, Pitt SC, Kilbane EM, Hall BL, Parmar AD et al. Distal pancreatectomy with celiac axis resection: What are the added risks? HPB. 2015 Sep 1;17(9):777-784. https://doi.org/10.1111/hpb.12453
    Beane, Joal D. ; House, Michael G. ; Pitt, Susan C. ; Kilbane, E. Molly ; Hall, Bruce L. ; Parmar, Abishek D. ; Riall, Taylor S. ; Pitt, Henry A. / Distal pancreatectomy with celiac axis resection : What are the added risks?. In: HPB. 2015 ; Vol. 17, No. 9. pp. 777-784.
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    abstract = "Background Reported series of a distal pancreatectomy with celiac axis resection (DP-CAR) are either small or not adequately controlled. The aim of this analysis was to report a multicentre series of modified Appleby procedures with a comparison group to determine the relative operative risk. Methods Data were gathered through the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over 14 months, 822 patients underwent a distal pancreatectomy at 43 institutions. Twenty of these patients (2.4{\%}) also underwent a celiac axis resection. DP-CAR patients were matched by age, gender, BMI, serum albumin, ASA class, gland texture, duct size and pathology to 172 patients undergoing DP alone. Results The majority of DP and DP-CAR patients had adenocarcinomas (61{\%} and 60{\%}). The median operative time for a DP alone was shorter than for a DP-CAR (207 versus 276 min, P < 0.01). Post-operative acute kidney injury (1{\%} versus 10{\%}, P < 0.03) and 30-day mortality were higher after a DP-CAR (1{\%} versus 10{\%}, P < 0.03). Conclusion A distal pancreatectomy with celiac axis resection is associated with increased operative time, post-operative acute kidney injury and a 10{\%} operative mortality. The decision to offer a modified Appleby procedure for a body of pancreas tumour should be made with full disclosure of the increased risks.",
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    N2 - Background Reported series of a distal pancreatectomy with celiac axis resection (DP-CAR) are either small or not adequately controlled. The aim of this analysis was to report a multicentre series of modified Appleby procedures with a comparison group to determine the relative operative risk. Methods Data were gathered through the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over 14 months, 822 patients underwent a distal pancreatectomy at 43 institutions. Twenty of these patients (2.4%) also underwent a celiac axis resection. DP-CAR patients were matched by age, gender, BMI, serum albumin, ASA class, gland texture, duct size and pathology to 172 patients undergoing DP alone. Results The majority of DP and DP-CAR patients had adenocarcinomas (61% and 60%). The median operative time for a DP alone was shorter than for a DP-CAR (207 versus 276 min, P < 0.01). Post-operative acute kidney injury (1% versus 10%, P < 0.03) and 30-day mortality were higher after a DP-CAR (1% versus 10%, P < 0.03). Conclusion A distal pancreatectomy with celiac axis resection is associated with increased operative time, post-operative acute kidney injury and a 10% operative mortality. The decision to offer a modified Appleby procedure for a body of pancreas tumour should be made with full disclosure of the increased risks.

    AB - Background Reported series of a distal pancreatectomy with celiac axis resection (DP-CAR) are either small or not adequately controlled. The aim of this analysis was to report a multicentre series of modified Appleby procedures with a comparison group to determine the relative operative risk. Methods Data were gathered through the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over 14 months, 822 patients underwent a distal pancreatectomy at 43 institutions. Twenty of these patients (2.4%) also underwent a celiac axis resection. DP-CAR patients were matched by age, gender, BMI, serum albumin, ASA class, gland texture, duct size and pathology to 172 patients undergoing DP alone. Results The majority of DP and DP-CAR patients had adenocarcinomas (61% and 60%). The median operative time for a DP alone was shorter than for a DP-CAR (207 versus 276 min, P < 0.01). Post-operative acute kidney injury (1% versus 10%, P < 0.03) and 30-day mortality were higher after a DP-CAR (1% versus 10%, P < 0.03). Conclusion A distal pancreatectomy with celiac axis resection is associated with increased operative time, post-operative acute kidney injury and a 10% operative mortality. The decision to offer a modified Appleby procedure for a body of pancreas tumour should be made with full disclosure of the increased risks.

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