Pancreatectomies Plus Celiac Trunk Resection: A Spanish Muticentre Study

Abstract

Background: Total pancreatectomy (TP), pancreatoduodenectomy (PD) and distal pancreatectomy (DP) with celiac axis resection (CAR) are performed in patients with locally advanced pancreatic cancer. The morbidity and mortality rates of these procedures are very high and the real benefit in a better survival rates is not fully confirmed. Objective: measuring morbidity and mortality at 90 days, hospital stay and survival rates in patients in which we performed TP/PD and DP + CAR and comparing both groups Methods: Observational retrospective multicentre study. Inclusion criteria: patient operated from a pancreatic cancer performing TP, PD or DP plus CAR in Spanish Surgical Departments. Data collection was closed 31 March 2018. Several preoperative, intraoperative and postoperative data were studied (Table 1). Complications were measured with Clavien classification at 90 days. Specific pancreatic complications were measured using ISGPS classifications. Chi-square or Student’s t tests were used to compare categorical or continuous variables, respectively. Kaplan–Meier estimator was used to calculate overall survival and survival differences were compared with the log-rank test. Data were analyzed using R version 3.1.3 (http://www.r-project.org). Level of significance was set at 0.05. Results: Table 1 shows the Results of the whole series (62 patients), the PD+TP (17) and DP group (45). Both groups were homogeneous. Operative time was longer in TP/PD group. Series morbidity was 84,9%, major morbidity (>IIIA) was 45.2 % and mortality 17.7%. Comparing morbidity and mortality of both groups, we did not find statistical differences. Series survival at 2 years is 40% but disease free survival is 0%. No statistical difference related to survival between both groups was found. Conclusion: CAR combined with pancreatectomy is a surgical procedure with high morbidity and mortality. In our series, 2-year survival is 40% but disease free survival is 0% Type of pancreatectomy is not related with survival, morbidity and mortality.Tabled 1Table 1.