دورية أكاديمية

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

التفاصيل البيبلوغرافية
العنوان: Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes ; International Retrospective Multicenter Study
المؤلفون: van Bodegraven, Eduard Antonie, Lof, Sanne, Jones, Leia, Aussilhou, Béatrice, Yong, Gao, Jishu, Wei, Klotz, Rosa, Rocha-Castellanos, Dario Missael, Matsumato, Ippei, de Ponthaud, Charles, Tanaka, Kimitaka, Biesel, Esther, Kauffmann, Emmanuele, Dumitrascu, Traian, Nagakawa, Yuichi, Martí-Cruchaga, Pablo, Roeyen, Geert, Zerbi, Alessandro, Goetz, Mara, de Meijer, Vincent, Pessaux, Patrick, Ignatavicius, Povilas, Demir, Ihsan, Giuffrida, Mario, Tingstedt, Bobby, Marino, Marco Vito, Mastoridis, Sotiris, Brunner, Maximilian, Mora-Oliver, Isabel, Bortolato, Cecilia, Gulla, Aisté, Apers, Thomas, Hermand, Hélène, Mitsuka, Yusuke, Popescu, Irinel, Boggi, Ugo, Wittel, Uwe, Hirano, Satoshi, Gaujoux, Sébastien, Kamei, Keiko, Fernández-Del Castillo, Carlos, Hackert, Thilo, Kuirong, Jiang, Yi, Miao, Sauvanet, Alain, Besselink, Marc, Abu Hilal, Mohammad, Dokmak, Safi
المصدر: Annals of Surgery ; ISSN 0003-4932
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2023
الوصف: Objective: To develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure. Summary Background Data: Central pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to 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). Primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk model were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation. Results: 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, BMI, and ASA score≥3. The model performed acceptable with an area under curve (AUC) of 0.72(CI:0.68-0.76). The risk model for endocrine dysfunction included higher BMI and male sex and performed well (AUC: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 and are readily available via www.pancreascalculator.com.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1097/sla.0000000000006157
DOI: 10.1097/SLA.0000000000006157
الإتاحة: https://doi.org/10.1097/sla.0000000000006157Test
حقوق: http://creativecommons.org/licenses/by/4.0Test/ http://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.A81766D2
قاعدة البيانات: BASE