Abstract
Purpose
Pancreatic surgery is a complex operation that has been associated with severe intraoperative and postoperative complications, especially in patients with previous abdominal surgery (PAS). Our study aimed to assess the impact of PAS on pancreatic surgery.
Methods
A total of 1430 patients who underwent pancreatic surgery were included in this retrospective study and classified into the following 3 groups: previous upper abdominal surgery (PUAS) (n = 135); previous lower abdominal surgery (PLAS) (n = 161), and no history of abdominal surgery (non-PAS) (n = 1134). Using propensity score matching (PSM), patients were matched to one another at a 1:1:1 ratio with balanced baseline characteristics. Intraoperative factors, surgical complications, hospital costs, and postoperative hospitalization were collected and compared.
Results
A longer operative duration was observed in the PUAS group compared to the non-PAS group (187.54 vs. 150.50 min, p = 0.016). The intraoperative blood loss in the PUAS group was significantly higher (193.68 vs. 150.51 and 156.81 mL, p < 0.05), while the intraoperative plasma transfusion volume was higher in PLAS patients than in non-PAS patients (183.8 vs. 102.7 mL, p = 0.008). Intra-abdominal adhesions in PUAS patients were most severe, and non-PAS patients exhibited significantly lower intra-abdominal adhesion grading (p < 0.001). No significant differences were observed in postoperative complications, postoperative histopathology, postoperative hospitalization, or hospital cost.
Conclusion
PAS has no significant influences on surgical outcomes, and pancreatic surgery is relatively safe in this patient population. A patient history of PAS may prolong operation duration and increase intraoperative blood loss but has no impact on postoperative complications and does not increase the economic burden.
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Change history
21 July 2022
A Correction to this paper has been published: https://doi.org/10.1007/s00423-022-02544-2
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Acknowledgements
The authors thank colleagues at the Department of Hepatobiliary Pancreatic Surgery in Changhai Hospital, Shanghai, China.
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All authors contributed significantly to this manuscript and are in agreement with the content. The authors contributed as follows: study conception and design: Kai-lian Zheng, Xiao-yi Yin, and Gang Jin; acquisition of data: Kai-lian Zheng, Xiao-yi Yin, and Hao-yu Gu; analysis and interpretation of data: Kai-lian Zheng, Xiao-yi Yin, and Hao-yu Gu; drafting of manuscript: Kai-lian Zheng, Xiao-yi Yin, and Hao-yu Gu; and critical revision of the manuscript: Chang-jin Li, Chen-ming Ni, Guo-xiao Zhang, Huan Wang, and Zhen Wang.
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This study was performed in line with the principles of the Declaration of Helsinki. The research study was conducted retrospectively from data obtained for clinical purposes. The Ethics Committee of Naval Medical University has confirmed that no ethical approval is required.
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Kai-lian Zheng, Xiao-yi Yin, and Hao-yu Gu contributed equally to this work and are considered as co-first authors.
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Zheng, Kl., Yin, Xy., Gu, Hy. et al. Impact of previous upper/lower abdominal surgery on pancreatic surgical outcomes and complications: a propensity score matching study. Langenbecks Arch Surg 407, 1517–1524 (2022). https://doi.org/10.1007/s00423-022-02494-9
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DOI: https://doi.org/10.1007/s00423-022-02494-9