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Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors?
SIMPLE SUMMARY: Acute pancreatitis can occur preoperatively in patients with periampullary tumors and cause technical difficulties in performing pancreatoduodenectomy. The aim of this retrospective study was to investigate how preoperative acute pancreatitis would affect postoperative outcomes and t...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8699028/ https://www.ncbi.nlm.nih.gov/pubmed/34944909 http://dx.doi.org/10.3390/cancers13246289 |
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author | Yoon, So Jeong Lee, Okjoo Jung, Ji Hye Shin, Sang Hyun Heo, Jin Seok Han, In Woong |
author_facet | Yoon, So Jeong Lee, Okjoo Jung, Ji Hye Shin, Sang Hyun Heo, Jin Seok Han, In Woong |
author_sort | Yoon, So Jeong |
collection | PubMed |
description | SIMPLE SUMMARY: Acute pancreatitis can occur preoperatively in patients with periampullary tumors and cause technical difficulties in performing pancreatoduodenectomy. The aim of this retrospective study was to investigate how preoperative acute pancreatitis would affect postoperative outcomes and to identify the optimal timing of surgery. There were more patients with operation failure (only exploration or unintended total pancreatectomy) in patients with pancreatitis, but no difference was found in rates of other complications. Moreover, when stratified by the timing of surgery, the surgical outcomes did not differ between the patients with and without pancreatitis. The results imply that in terms of surgical complications, pancreatoduodenectomy could be safely performed in patients with preoperative pancreatitis. Further research is necessary to identify safe conditions and proper timing of surgery for patients with preoperative pancreatitis. ABSTRACT: Preoperative acute pancreatitis (PAP) in patients with periampullary tumor can cause technical difficulties when performing pancreatoduodenectomy (PD) but perioperative risks of PAP remain unclear. The purpose of this study was to investigate the impact of PAP on surgical outcomes and determine the optimal timing of PD. Patients undergoing surgery for periampullary tumors between 2009 and 2018 were included. Simple random sampling (1:4) was performed to compare outcomes between the PAP group and the control group. Operative failure was defined as exploration-only or unwanted total pancreatectomy. The rate of operative failure was higher in the PAP group than in the control group (6.6% vs. 0%, p < 0.001). There was no significant difference in postoperative outcomes including complications or in-hospital mortality between the two groups. Surgical outcomes were compared after dividing PAP groups by intervals (2, 3, or 4 weeks) between the onset of PAP and surgery, and there were no differences between the groups. In conclusion, in spite of the increased risk of operation failure, PD could be performed in PAP patients at comparable rates of postoperative complications. Further study is needed to select patients with PAP in proper conditions for performing PD. |
format | Online Article Text |
id | pubmed-8699028 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86990282021-12-24 Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? Yoon, So Jeong Lee, Okjoo Jung, Ji Hye Shin, Sang Hyun Heo, Jin Seok Han, In Woong Cancers (Basel) Article SIMPLE SUMMARY: Acute pancreatitis can occur preoperatively in patients with periampullary tumors and cause technical difficulties in performing pancreatoduodenectomy. The aim of this retrospective study was to investigate how preoperative acute pancreatitis would affect postoperative outcomes and to identify the optimal timing of surgery. There were more patients with operation failure (only exploration or unintended total pancreatectomy) in patients with pancreatitis, but no difference was found in rates of other complications. Moreover, when stratified by the timing of surgery, the surgical outcomes did not differ between the patients with and without pancreatitis. The results imply that in terms of surgical complications, pancreatoduodenectomy could be safely performed in patients with preoperative pancreatitis. Further research is necessary to identify safe conditions and proper timing of surgery for patients with preoperative pancreatitis. ABSTRACT: Preoperative acute pancreatitis (PAP) in patients with periampullary tumor can cause technical difficulties when performing pancreatoduodenectomy (PD) but perioperative risks of PAP remain unclear. The purpose of this study was to investigate the impact of PAP on surgical outcomes and determine the optimal timing of PD. Patients undergoing surgery for periampullary tumors between 2009 and 2018 were included. Simple random sampling (1:4) was performed to compare outcomes between the PAP group and the control group. Operative failure was defined as exploration-only or unwanted total pancreatectomy. The rate of operative failure was higher in the PAP group than in the control group (6.6% vs. 0%, p < 0.001). There was no significant difference in postoperative outcomes including complications or in-hospital mortality between the two groups. Surgical outcomes were compared after dividing PAP groups by intervals (2, 3, or 4 weeks) between the onset of PAP and surgery, and there were no differences between the groups. In conclusion, in spite of the increased risk of operation failure, PD could be performed in PAP patients at comparable rates of postoperative complications. Further study is needed to select patients with PAP in proper conditions for performing PD. MDPI 2021-12-15 /pmc/articles/PMC8699028/ /pubmed/34944909 http://dx.doi.org/10.3390/cancers13246289 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Yoon, So Jeong Lee, Okjoo Jung, Ji Hye Shin, Sang Hyun Heo, Jin Seok Han, In Woong Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title | Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title_full | Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title_fullStr | Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title_full_unstemmed | Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title_short | Does Preoperative Acute Pancreatitis Inevitably Delay Pancreatoduodenectomy in Patients with Periampullary Tumors? |
title_sort | does preoperative acute pancreatitis inevitably delay pancreatoduodenectomy in patients with periampullary tumors? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8699028/ https://www.ncbi.nlm.nih.gov/pubmed/34944909 http://dx.doi.org/10.3390/cancers13246289 |
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