Impact of pulmonary embolism on morbidity and mortality in patients undergoing pancreatic surgery

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Purpose: Postoperative pulmonary embolism (PE) after pancreatic surgery is a potentially life-threatening complication. However, the magnitude of morbidity and mortality of PE is still uncertain. The present study aims to assess the incidence of PE after pancreatic surgery and analyze its impact on the outcome. Methods: We conducted a retrospective study including all patients who underwent pancreatic resections between 2005 and 2017. The development of PE was analyzed for a 90-day period following surgery. Risk factors were evaluated using regression models. Results: The study investigated 947 patients undergoing pancreatic surgery. Overall, 26 (2.7%) patients developed PE. The median body mass index (BMI) of patients with PE was significantly higher (28.1 kg/m2 [24.7–31.8] vs. 24.8 kg/m2 [22.4–27.8], p < 0.001). Patients with PE had a significantly increased duration of the operation and more often underwent multivisceral resections. The lowest incidence of PE was found after distal or total pancreatectomy (2%). In median, PE occurred on the fifth postoperative day (interquartile range: 3–9). Increased BMI, duration of operation, and postoperative deep venous thrombosis were found to be multivariate risk factors for the development of PE. Importantly, postoperative complications (53.8% vs. 15.1%, p < 0.001) and the 30-day mortality rate were significantly increased in the PE group (19.2% vs. 3.3%, p < 0.001). Conclusions: Patients with increased BMI, a history of deep venous thrombosis, and multivisceral resections are a high-risk group for PE after pancreatic surgery. While the absolute incidence and related mortality of PE after pancreatic surgery is low, it is associated with severe sequelae.

Details

Original languageEnglish
Pages (from-to)893-902
Number of pages10
JournalLangenbeck's archives of surgery
Volume406
Issue number3
Publication statusPublished - May 2021
Peer-reviewedYes

External IDs

PubMed 33037463

Keywords

ASJC Scopus subject areas

Keywords

  • Deep venous thrombosis, Pancreatic surgery, Pulmonary embolism, Venous thromboembolism