Textbook outcome after pancreatoduodenectomy and distal pancreatectomy with postoperative hyperamylasemia—a propensity score matching analysis

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

Purpose: Postoperative serum hyperamylasemia (POH) is a part of the new, increasingly highlighted, definition for postpancreatectomy pancreatitis (PPAP). This study aimed to analyze whether the biochemical changes of PPAP are differently associated with postoperative complications after distal pancreatectomy (DP) compared with pancreatoduodenectomy (PD). The textbook outcome (TO) was used as a summary measure to capture real-world data. Methods: The data were retrospectively extracted from a prospective clinical database. Patients with POH, defined as levels above our institution's upper limit of normal on postoperative day 1, after DP and the corresponding propensity score–matched cohort after PD were evaluated on postoperative complications by using logistic regression analyses. Results: We analyzed 723 patients who underwent PD and DP over a period of 9 years. After propensity score matching, 384 patients (192 patients in each group) remained. POH was observed in 78 (41.1%) and 74 (39.4%) after PD and DP correspondingly. There was a significant increase of postoperative complications in the PD group: Clavien-Dindo classification system ≥3 (P < .01 vs P = .71), clinically relevant postoperative pancreatic fistula (P < .001 vs P = .2), postpancreatectomy hemorrhage (P < .001 vs P = .11), and length of hospital stay (P < .001 vs P = .69) if POH occurred compared with in the DP group. TO was significantly unlikely in cases with POH after PD compared with DP (P > .001 vs P = .41). Furthermore, POH was found to be an independent predictor for missing TO after PD (odds ratio [OR], 0.29; 95% CI, 0.14-0.60; P < .001), whereas this was not observed in patients after DP (OR, 0.53; 95% CI, 0.21-1.33; P = .18). Conclusion: As a part of the definition for PPAP, POH is a predictive indicator associated with postoperative complications after PD but not after DP.

Details

OriginalspracheEnglisch
Seiten (von - bis)451-457
Seitenumfang7
FachzeitschriftJournal of gastrointestinal surgery
Jahrgang28
Ausgabenummer4
PublikationsstatusVeröffentlicht - Apr. 2024
Peer-Review-StatusJa

Externe IDs

PubMed 38583895

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Pancreatectomy, Pancreatic fistula, Postoperative hyperamylasemia, Postpancreatectomy pancreatitis, Textbook outcomes, Pancreatic Fistula/epidemiology, Prospective Studies, Humans, Pancreaticoduodenectomy/adverse effects, Hyperamylasemia/complications, Pancreatectomy/adverse effects, Propensity Score, Postoperative Complications/epidemiology, Retrospective Studies, Pancreatitis/complications, Propylamines