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

  • Original Article
  • Published:
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.

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Data Availability

The data supporting the findings and conclusions of this study is available within the article.

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Funding

This work was supported by National Institutes of Health T32 CA 009599 and the MD Anderson Cancer Center support grant (P30 CA016672).

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    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

  2. Department of Genetics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT17.6006, Unit 1484, Houston, TX, 77030, USA

    Michael P. Kim

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  1. Eileen C. Donovan
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Conception and design, and/or acquisition of data, and/or analysis and interpretation of data: all authors. Drafting the article or revising it critically for important intellectual content: all authors. Final approval of the version to be published: all authors.

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Correspondence to Michael P. Kim.

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Meeting Presentation: The Society for Surgery of the Alimentary Tract (SSAT) Virtual 62nd Annual Meeting, May 21–23, 2021.

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Donovan, E.C., Prakash, L.R., Chiang, YJ. et al. Incidence of Postoperative Complications Following Pancreatectomy for Pancreatic Cystic Lesions or Pancreatic Cancer. J Gastrointest Surg 27, 319–327 (2023). https://doi.org/10.1007/s11605-022-05534-3

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