Distal pancreatectomy with celiac axis resection: what are the added risks?

• Published in: HPB (Oxford, England) England), 2015-09, Vol.17 (9), p.777-784
• Main Authors: Beane, Joal D, House, Michael G, Pitt, Susan C, Molly Kilbane, E, Hall, Bruce L, Parmar, Abishek D, Riall, Taylor S, Pitt, Henry A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Celiac Plexus - surgery; Female; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Incidence; Male; Middle Aged; Neoplasm Staging; Original; Pancreatectomy - methods; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Postoperative Complications - epidemiology; Prospective Studies; Survival Rate - trends; Treatment Outcome; United States - epidemiology
• ISSN: 1365-182X; 1477-2574
• DOI: 10.1111/hpb.12453

Abstract Background Reported series of a distal pancreatectomy with celiac axis resection (DP‐CAR) are either small or not adequately controlled. The aim of this analysis was to report a multicentre series of modified Appleby procedures with a comparison group to determine the relative operative risk. Methods Data were gathered through the American College of Surgeons‐National Surgical Quality Improvement Program (ACS‐NSQIP) Pancreatectomy Demonstration Project. Over 14 months, 822 patients underwent a distal pancreatectomy at 43 institutions. Twenty of these patients (2.4%) also underwent a celiac axis resection. DP‐CAR patients were matched by age, gender, BMI, serum albumin, ASA class, gland texture, duct size and pathology to 172 patients undergoing DP alone. Results The majority of DP and DP‐CAR patients had adenocarcinomas (61% and 60%). The median operative time for a DP alone was shorter than for a DP‐CAR (207 versus 276 min, P < 0.01). Post‐operative acute kidney injury (1% versus 10%, P