BackgroundPancreatic resection with concomitant vascular resection is increasingly practiced with outcomes mainly reported from specialist centers but lacking results from prospective global data. This study aimed to investigate factors associated with short-term outcomes after vascular resections in pancreatic surgery worldwide.Patients and MethodsData were extracted from a prospective, multicenter, international cross-sectional snapshot study in 2021 (pancreasgroup.org) assessing short-term outcomes after pancreatic surgery worldwide (NCT04652271). In the patient cohort of pancreatic surgery with simultaneous vascular resection for various diseases, short-term outcomes were reported and compared with established benchmark values. Factors affecting major complications, mortality, and histopathological resection status were assessed in multivariable logistic regression analyses with interaction testing.ResultsFrom a total of 3926 patients undergoing pancreatic surgery, 565 had associated vascular resections, of which 444 had venous resections alone and 121 had arterial resections alone or with concomitant venous resection. Of the 153 (47%) benchmark cases with pancreatoduodenectomy and venous resection, median postoperative morbidity fell within established benchmark criteria. Median 90-day major complication and mortality rates were similar in pancreatic resection with venous, arterial or no vascular resections (45 and 10%, 47 and 6.6%, 42 and 9.6% respectively). Patients undergoing arterial resections that developed a clinically relevant pancreatic fistula faced substantially elevated odds of 90-day mortality (OR 8.8 CI 1.6-48). In pancreatic ductal adenocarcinoma, the R1 rate was 26%, neoadjuvant chemotherapy being protective for both overall and venous-specific margins.ConclusionsVascular pancreatic surgery is performed across diverse healthcare settings worldwide. While perioperative complications were comparable to nonvascular pancreatic resections, the observed 90-day mortality was considerable overall. International collaborative efforts should focus on understanding practice variations and improve accessibility of optimal perioperative care to promote rescue capabilities.
Analysis of Short-Term Outcomes in Pancreatic Surgery with Vascular Resection from a Prospective Multicenter Global Study / Tinguely, Pascale; Hidalgo Salinas, Camila; Staubli, Sebastian M.; Raptis, Dimitri A.; Fusai, Giuseppe K.; Hilal, Mohamed Abu; Bassi, Claudio; Besselink, Marc; Conlon, Kevin; Davidson, Brian; Del Chiaro, Marco; Dervenis, Christos; Falconi, Massimo; Hackert, Thilo; Harrison, Ewen; Shrikhande, Shailesh V.; Siriwardena, Ajith; Smith, Martin; Wolfgang, Christopher; Borakati, Aditya; Balci, Deniz; Machairas, Nikolaos; Marchegiani, Giovanni; Oba, Atsushi; Oberkofler, Christian; Passas, Ioannis; Ravikumar, Reena; Velázquez, Patricia Sánchez; De Santibañes, Martin; Schnitzbauer, Andreas Anton; Soggiu, Fiammetta; Tamburrino, Domenico; Wei, Alice; Zachiotis, Marinos; Bentabak, Kamel; Kacimi, Salah Eddine; Nikfarjam, Mehrdad; Shcherba, Aliaksei; Sergeant, Gregory; Coelho, Gustavo; Torres, Orlando; Belev, Nikolay; Fabrice, Burundi; Tang, Ephraim; Martin, Janet; Diaz, Christian; Devaud, Nicolas; Wei, Kongyuan; Hendi, Maher; Mikulic, Danko; Gouvas, Nikolaos; Nikov, Andrej; Fathallah, Dalia; Saad, Mahmoud; Tammik, Olav; Huhta, Heikki; Sulpice, Laurent; Lupinacci, Renato; Stavrou, Gregor; Felekouras, Evangelos; Papaziogas, Vasileios; Misra, Sanjeev; Prabowo, Erik; Hashim, Hashim Talib; Al-Sader, Maytham Al-Juaifari; Satoi, Sohei; Obeidat, Khaled; Mohsen, Maram; Han, Ho-Seong; Khalife, Mohamad; Elhadi, Muhammed; Dulskas, Audrius; Bong, Jin; Ghani, Shahi; Padilla, Alejandro Eduardo; Melchor-Ruan, Javier; Erdene, Sarnai; Benkabbou, Amine; Nashidengo, Pueya; Koea, Jonathan; Adeyeye, Ademola; Alatise, Olusegun; Ullah, Sami; Jayyab, Mustafa Abu; Amro, Sarah; Alnammourah, Walaa Mohammed; The, Catherine; Pędziwiatr, Michał; Polkowski, Wojciech; Barbu, Sorin; Karamarkovic, Aleksandar; Galun, Daniel; Goh, Brian; Trotovšek, Blaž; Omoshoro-Jones, Jones; Ielpo, Benedetto; Abdelmageed, Abdelfatah; Sandström, Per; Cristaudi, Alessandra; Gloor, Beat; Kuemmerli, Christoph; Tishreen, Alaa Hamdan; Chaaban, Mohammad Karam; Wu, Chien Hui; Jen, Po-Chih Yang Fu; Houssem, Ammar; Baraket, Oussama; Çoker, Ahmet; Taylor, Mark; Jamieson, Nigel; Iype, Satheesh; Giorgakis, Emmanouil; Qadan, Motaz; Ganai, Sabha; Al-Naggar, Hamza; Chihaka, Onesai; Behi, Amor El; Tidjane, Anisse; Ouahab, Ilhem; Bouaoud, Souad; Rais, Mounira; Abdoun, Meriem; Ouyahia, Amel; Mc Cormack, Lucas; De Santibanes, Martin; Schelotto, Pablo Barros; Joglekar, Shantanu; Gananadha, Sivakumar; Hall, Kat; Hodgson, Russell; Rowcroft, Alistair; Chong, Lynn; Shah, Kalpesh; Chen, Stanley; Burnett, David; Ng, Zi Qin; Apostolou, Christos; Kornprat, Peter; Stoyanova, Radoslava; Shcherba, Aliaksei; Van Den Bossche, Bert; Hartman, Vera; Gryspeerdt, Filip; Berrevoet, Frederik; Strypstein, Sébastien; Pinto, Rinaldo; Coelho, Gustavo; Militz, Matheus; Rodrigues, Pablo; Torres, Orlando; Marques, Narimã; Sampaio, Adriano; Krastev, Panche; Slavchev, Mihail; Takorov, Ivelin; Vladov, Nikola; Mihaylov, Vassil; Nikolaev, Evgeni; Kostov, Daniel; Serrano, Pablo; Diaz, Cristian; Brañes, Alejandro; Cai, Lei; Chen, Yiming; Štironja, Ivan; Bubalo, Tomislav; Loveček, Martin; Zaruba, Pavel; Nikov, Andrej; Attalla, Almoatazbellah; Tayiawi, Mosaab; Alboridy, Muneera; Mourad, Mohamed; Elkeleny, Mostafa; Tanas, Yousef; Ealreibi, Hajer; Moneam, Mohamed Abd El; Hamouda, Mohammed; Nafea, Ahmed; Abdelalemm, Mohamed; Mansour, Ahmed; Farag, Marina; Salah, Mohamed; Abdelkarem, Mohamed; Sayed, Hatem; Diab, Sherein; Gobran, Mira; Fahim, Abdelrahman; Awad, Ahmed K.; Abdelmawgoud, Sherif; Alazab, Emad; Nagy, Mostafa; Metwally, Islam; Shehta, Ahmed; Monier, Ahmed; Awad, Selmy; Omar, Mohammed; Alsabbagh, Feras; Kauppila, Joonas; Nortunen, Minna; Huhta, Heikki; Brustia, Raffaele; Truant, Stéphanie; Piessen, Guillaume; Dupré, Aurélien; Souche, Francois-Regis; Savala, Natalia; Lupinacci, Renato; Gaujoux, Sébastien; Goasguen, Nicolas; Anyla, Morgan; Schwarz, Lilian; Giannone, Fabio; Demetrashvili, Zaza; Bartella, Isabel; Pozios, Ioannis; Belyaev, Orlin; Bulian, Dirk; Praetorius, Christian; Korn, Sandra; Brunner, Maximilian; Mazzella, Elena; Reichert, Martin; Gaedcke, Jochen; Ronellenfitsch, Ulrich; Reese, Tim; Wagner, Kim; Scognamiglio, Pasquale; Uzunoglu, Faik; Izbicki, Jakob; Struecker, Benjamin; Kardassis, Dimitrios; Nadalin, Silvio; Makridis, Georgios; Tsoukalas, Nikolaos; Kechagias, Aristotelis; Ioannidis, Argyrios; Arkadopoulos, Nikolaos; Papakonstantinou, Dimitrios; Michalopoulos, Nikolaos; Kokoropoulos, Panagiotis; Vassiliu, Pantelis; Stergiou, Dimitrios; Sotiropoulou, Maria; Tomara, Nefeli; Dorovinis, Panagiotis; Tzimas, George; Schizas, Dimitrios; Papalampros, Alexandros; Polydorou, Andreas; Fragulidis, Georgios; Toutouzas, Konstantinos; Vezakis, Antonios; Bramis, Konstantinos; Korkolis, Dimitrios; Fradelos, Evangelos; Glantzounis, Georgios; Magouliotis, Dimitrios; Christodoulidis, Grigorios; Mulita, Francesk; Kontis, Elissaios; Papaziogas, Vasileios; Giakoustidis, Dimitris; Katsourakis, Anastasios; Νtinas, Achilleas; Petras, Panagiotis; Bursics, Attila; Vereczkei, Andras; Karuparthi, Sreenivasan; Purushothaman, Govind; Gupta, Rahul; Yadav, Kaushal; Jain, Sundeep; Vishnoi, Jeewan Ram; Misra, Sanjeev; Varshney, Vaibhav; Das, Kshaunish; Chattopadhyay, Somnath; Velagala, Jayapala Reddy; Bansal, Varun; S, Induchoodan; Kumar, Tarun; Prabowo, Erik; Hashim, Hashim Talib; Al-Juaifari, Maytham; Sadot, Eran; Vivarelli, Marco; Andriola, Valeria; Ciola, Michele; Papa, Mario Virgilio; Antonucci, Adelmo; Sasia, Diego; Testa, Valentina; Bencini, Lapo; Nelli, Tommaso; D'Acapito, Fabrizio; Pacilio, Carlo Alberto; Carganico, Giacomo; De Rosa, Raffaele; D'Ugo, Stefano; Saladino, Edoardo; Recordare, Alfonso; Mazzola, Michele; Mazzaferro, Vincenzo; Zerbi, Alessandro; Tamburrino, Domenico; Baldi, Caterina; Stella, Marco; Di Benedetto, Fabrizio; Uggeri, Fabio; Iacomino, Alessandro; Rompianesi, Gianluca; Belli, Andrea; Moletta, Lucia; Tolin, Francesca; Giuffrida, Mario; Cobianchi, Lorenzo; Regi, Paolo; Morelli, Luca; Kauffmann, Emanuele Federico; Pinotti, Enrico; Giuliante, Felice; Coppola, Alessandro; Manzia, Tommaso Maria; Porcu, Alberto; Feo, Claudio; Perra, Teresa; Ciarleglio, Francesco; Novello, Simone; Ferrero, Alessandro; Intini, Sergio; Querini, Giorgio; Ruzzenente, Andrea; Campagnaro, Tommaso; Conci, Simone; Napetti, Sara; Frontali, Alice; Hashimoto, Daisuke; Matsumoto, Ippei; Maehira, Hiromitsu; Tanabe, Minoru; Alissawi, Subhi; Obed, Aiman; Rababa, Hebah; Al-Shami, Khayry; Alsabah, Mohamed; Shumrakh, Saeed; Al-Samawi, Abdulaziz; Khamees, Almu'Atasim; Fakhradiyev, Ildar; Han, Ho-Seong; Atstupens, Kristaps; Faraj, Walid; Khalife, Mohamad; Alowjali, Fatoom; Alshatshat, Abdulhadi; Benamwor, Aihab; Younes, Eman; Burgan, Dania; Morgom, Marwa; Binnawara, Muhannud; Alshareea, Entisar; Ahmeed Ahmeed, Sultan; Othman, Eman; Gerwash, Ahmed; Salem, Osama; Khalil, Wegdan; Abdulwahed, Eman; Alharari, Mohamed; Vanagas, Tomas; Eismontas, Vitalijus; Jurgaitis, Jonas; Slepavicius, Algirdas; Mikutaitis, Vytenis; Kvietkauskas, Mindaugas; Rosso, Edoardo; Zakaria, Andee Dzulkarnaen; Chik, Ian; Bong, Jin; Zorrilla, Carlos Florez; Erdene, Sarnai; Korch, Moniba; Gouazar, Iltimass; Serji, Badr; Zentar, Aziz; Benkabbou, Amine; Elhassouni, Reda; Echiguer, Sabrillah; Majbar, Mohammed Anass; Nashidengo, Abdulrashid Pueya; Lakhey, Paleswan Joshi; Windsor, John; Chu, Michael Jen Jie; Johnston, Peter; Bindra, Vanshay; Cross, Andrea; Gunawardene, Ashok; Welsh, Fraser; Alatise, Olusegun; Abbasy, Jibran; Siddiqui, Tayyab; Asghar, Mohammad; Jayyab, Mustafa Abu; Zreqat, Qusai; Titi, Rawand; Manasrah, Fatima; Hammoudeh, Ahlam; Coayla, Guillermo; Teh, Catherine; Alfonso, Cenon; Flisińska, Marta; Rymarowicz, Justyna; Sierzega, Marek; Ciesielski, Wojciech; Grząsiak, Oliwia; Szewczyk, Patrycja; Szwedziak, Krzysztof; Korcz, Wojciech; Kornasiewicz, Oskar; Vigia, Emanuel; Radulescu, Raluca Bievel; Dumitrascu, Traian; Mardare, Mara; Ginghina, Octav; Brezean, Iulian; Petrea, Sorin; Bartos, Adrian; Bodea, Raluca; Matei, Sergiu; Musina, Ana-Maria; Velenciuc, Natalia; Belyaev, Alexander; Mizgirev, Denis; Litvin, Andrey; Semenenko, Ivan; Bedzhanyan, Arkady; Bagmet, Nikolay; Kaldarov, Ayrat; Kuchin, Denis; Drozdov, Evgeniy; Gachabayov, Mahir; Alharthi, Mohammed; Bogdanovic, Aleksandar; Galun, Daniel; Kmezic, Stefan; Arbutina, Dragana; Bezmarevic, Mihailo; Juloski, Jovan; Protic, Mladjan; Goh, Brian; Trotovšek, Blaž; Loots, Emil; Omoshoro-Jones, Jones; Marcello, Manuel; Ramia, Jose; Del Mar Rico-Morales, Maria; Ausania, Fabio; Arnau, Ana Belen Martin; Ielpo, Benedetto; Santos, Esther Pilar; Ruiz, Patricia; Falgueras, Laia; Al Shwely, Farah; Busquets, Juli; Justo, Iago; Dziakova, Jana; Di Martino, Marcello; Suárez-Muñoz, Miguel Ángel; García, Lorena Solar; Segura-Sampedro, Juan Jose; Rotellar, Fernando; Muñoz-Bellvis, Luis; Vera, Valle; Domingo, María García; Pozo, Carlos Domingo-Del; Ibáñez, Cristina Ballester; Dorcaratto, Dimitri; Rodriguez-Lopez, Mario; Serrablo, Alejandro; Hamid, Hytham; Abdelmageed, Abdelfatah; Sandström, Per; Lundgren, Linda; Tingstedt, Bobby; Williamsson, Caroline; Andersson, Bodil; Sparrelid, Ernesto; Kuemmerli, Christoph; Moeckli, Beat; Cristaudi, Alessandra; Abbassi, Fariba; Schmidt, Jan; Gutknecht, Stefan; Jonas, Jan Philipp; Alhashemi, Mais; Douba, Zain; Kayali, Ahmad; Azizeh, Oula; Al-Abed, Omar; Abdulmonem, Aya; Alhouri, Ahmad; Al Houri, Hasan; Suliman, Alnour; Hassan, Bashar Haj; Hamdan, Alaa; Yu, Ming-Chin; Bouaziz, Hanen; Kchaou, Ali; Houssem, Ammar; Tez, Mesut; Kerem, Mustafa; Bayhan, Hüseyin; Aday, Ulaş; Gumusoglu, Alpen; Aydin, Husnu; Hanefa, Fatema; Atici, Ali Emre; Ulgur, Hanife; Sert, Ismail; Atici, Semra Demirli; Colak, Elif; Skoryi, Denys; Kopchak, Kostiantyn; Kvasivka, Oleksandr; Sumarokova, Valeriia; Skipworth, James; Lim, William; Mohamed, Ahmed; Tinguely, Pascale; Kocher, Hemant; Khalil, Amjad; Carino, Nicola De' Liguori; Gareb, Fahed; Sanjay, Pandanaboyana; Patel, Krishnakumure; Ceresa, Carlo; Russell, Thomas; Mortimer, Matt; Sulciner, Megan; Clancy, Thomas; Nebbia, Martina; Thompson, Rachel; Moris, Dimitrios; Gnerlich, Jennifer; Spencer-Cole, Richard; Krinock, Derek; Osborn, Tamara; Hardgrave, Hailey; Nigh, Joe; Schrope, Beth; Lamm, Ryan; Lavu, Harish; Bowne, Wilbur; Sham, Jonathan; Martins, Paulo; Albar, Aisha; Al-Eryani, Fatima; Al-Naggar, Hamza; Al-Saban, Rafat. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - (2025). [10.1245/s10434-025-17911-8]
Analysis of Short-Term Outcomes in Pancreatic Surgery with Vascular Resection from a Prospective Multicenter Global Study
Porcu, AlbertoMembro del Collaboration Group
;Perra, TeresaMembro del Collaboration Group
;
2025-01-01
Abstract
BackgroundPancreatic resection with concomitant vascular resection is increasingly practiced with outcomes mainly reported from specialist centers but lacking results from prospective global data. This study aimed to investigate factors associated with short-term outcomes after vascular resections in pancreatic surgery worldwide.Patients and MethodsData were extracted from a prospective, multicenter, international cross-sectional snapshot study in 2021 (pancreasgroup.org) assessing short-term outcomes after pancreatic surgery worldwide (NCT04652271). In the patient cohort of pancreatic surgery with simultaneous vascular resection for various diseases, short-term outcomes were reported and compared with established benchmark values. Factors affecting major complications, mortality, and histopathological resection status were assessed in multivariable logistic regression analyses with interaction testing.ResultsFrom a total of 3926 patients undergoing pancreatic surgery, 565 had associated vascular resections, of which 444 had venous resections alone and 121 had arterial resections alone or with concomitant venous resection. Of the 153 (47%) benchmark cases with pancreatoduodenectomy and venous resection, median postoperative morbidity fell within established benchmark criteria. Median 90-day major complication and mortality rates were similar in pancreatic resection with venous, arterial or no vascular resections (45 and 10%, 47 and 6.6%, 42 and 9.6% respectively). Patients undergoing arterial resections that developed a clinically relevant pancreatic fistula faced substantially elevated odds of 90-day mortality (OR 8.8 CI 1.6-48). In pancreatic ductal adenocarcinoma, the R1 rate was 26%, neoadjuvant chemotherapy being protective for both overall and venous-specific margins.ConclusionsVascular pancreatic surgery is performed across diverse healthcare settings worldwide. While perioperative complications were comparable to nonvascular pancreatic resections, the observed 90-day mortality was considerable overall. International collaborative efforts should focus on understanding practice variations and improve accessibility of optimal perioperative care to promote rescue capabilities.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
