Influence of Hemorrhagic Complications of Pancreatoduodenectomy in Patients with Cancer on Short- and Long-Term Mortality

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Apr 28

PMID 37109189

Authors

Alexandre Thobie

Fabien Robin

Benjamin Menahem

Jean Lubrano

Karim Boudjema

Arnaud Alves

Olivier Dejardin

Laurent Sulpice

Affiliations

Soon will be listed here.

Abstract

Background: With a mortality rate of up to 30%, post-pancreatectomy hemorrhage (PPH) remains a serious complication after pancreatoduodenectomy (PD) for cancer. Little is known about the long-term survival of patients after PPH. This retrospective study aimed to evaluate the impact of PPH on long-term survival after PD.

Methods: The study included 830 patients (PPH, n = 101; non-PPH, n = 729) from two centers, who underwent PD for oncological indications. PPH was defined as any bleeding event occurring within 90 days after surgery. A flexible parametric survival model was used to determine the evolution of the risk of death over time.

Results: At postoperative day 90, PPH significantly increased the mortality rate (PPH vs. non-PPH: 19.8% vs. 3.7%, < 0.0001) and severe postoperative complication rate (85.1% vs. 14.1%, < 0.0001), and decreased median survival (18.6 months vs. 30.1 months, = 0.0001). PPH was associated with an increased mortality risk until the sixth postoperative month. After this 6-month period, PPH had no more influence on mortality.

Conclusions: PPH had a negative impact on the short-term overall survival beyond postoperative day 90 and up to six months after PD. However, compared to non-PPH patients, this adverse event had no impact on mortality after a 6-month period.

Citing Articles

Machine learning approach to predict postpancreatectomy hemorrhage following pancreaticoduodenectomy: a retrospective study.

Ikuta S, Fujikawa M, Nakajima T, Kasai M, Aihara T, Yamanaka N Langenbecks Arch Surg. 2024; 409(1):29.

PMID: 38183456 DOI: 10.1007/s00423-023-03223-6.

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