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Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To identify the current indications and outcomes of total pancreatectomy at a high-volume center.

Methods: A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.

Results: One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7.8%), pancreatic neuroendocrine tumors (n = 7, 6.8%), and miscellaneous (n = 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.

Conclusion: Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier curve for survival. A: Survival in patients with pancreatic ductal adenocarcinoma; B: Survival in patients with intraductal papillary mucinous neoplasms. PDAC: Pancreatic ductal adenocarcinoma; IPMN: Intraductal papillary mucinous neoplasms.
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Figure 1: Kaplan Meier curve for survival. A: Survival in patients with pancreatic ductal adenocarcinoma; B: Survival in patients with intraductal papillary mucinous neoplasms. PDAC: Pancreatic ductal adenocarcinoma; IPMN: Intraductal papillary mucinous neoplasms.

Mentions: Overall, the 90-d perioperative mortality was 7 patients (6.8%). The 1-, 3-, 5-, and 7-year total survival rate for all 103 patients were 73.7%, 61.3%, 57.5%, and 53.8%, respectively (Figure 1A). The 1-, 3-, 5-, and 7-year survival for patients without malignant tumors (50 patients) were 84%, 82%, 79.5%, and 75.9%, respectively, while in patients with malignant findings (53 patients) the survival rates were 64%, 40.4%, 34.7%, and 30.9%, respectively. The 1-, 3-, 5-, and 7-year survival rates in patients who had PDAC (42 patients) were 59.5%, 29.2%, 21.9%, and 18.3%, respectively (Figure 1B).


Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center
Kaplan Meier curve for survival. A: Survival in patients with pancreatic ductal adenocarcinoma; B: Survival in patients with intraductal papillary mucinous neoplasms. PDAC: Pancreatic ductal adenocarcinoma; IPMN: Intraductal papillary mucinous neoplasms.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037337&req=5

Figure 1: Kaplan Meier curve for survival. A: Survival in patients with pancreatic ductal adenocarcinoma; B: Survival in patients with intraductal papillary mucinous neoplasms. PDAC: Pancreatic ductal adenocarcinoma; IPMN: Intraductal papillary mucinous neoplasms.
Mentions: Overall, the 90-d perioperative mortality was 7 patients (6.8%). The 1-, 3-, 5-, and 7-year total survival rate for all 103 patients were 73.7%, 61.3%, 57.5%, and 53.8%, respectively (Figure 1A). The 1-, 3-, 5-, and 7-year survival for patients without malignant tumors (50 patients) were 84%, 82%, 79.5%, and 75.9%, respectively, while in patients with malignant findings (53 patients) the survival rates were 64%, 40.4%, 34.7%, and 30.9%, respectively. The 1-, 3-, 5-, and 7-year survival rates in patients who had PDAC (42 patients) were 59.5%, 29.2%, 21.9%, and 18.3%, respectively (Figure 1B).

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To identify the current indications and outcomes of total pancreatectomy at a high-volume center.

Methods: A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.

Results: One hundred and three patients underwent total pancreatectomy for indications including: Pancreatic ductal adenocarcinoma (n = 42, 40.8%), intraductal papillary mucinous neoplasms (n = 40, 38.8%), chronic pancreatitis (n = 8, 7.8%), pancreatic neuroendocrine tumors (n = 7, 6.8%), and miscellaneous (n = 6, 5.8%). The mean age was 66.2 years, and 59 (57.3%) were female. Twenty-four patients (23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24 (23.3%) and 18 patients (17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.

Conclusion: Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

No MeSH data available.


Related in: MedlinePlus