Predictors of post-operative pancreatic fistula formation in pancreatic neuroendocrine tumors: A national surgical quality improvement program analysis

Abstract

BackgroundPost-operative pancreatic fistula (POPF) is a serious complication following pancreas surgery. We aimed to establish factors associated with POPF specifically in patients with pancreatic neuroendocrine tumors (PNET). MethodsThe 2014–2018 American College of Surgeons National Surgical Quality Improvement Program database was querried for patients undergoing resection for PNET. The impact of patient, tumor, and operative factors on POPF formation was evaluated. Results3532 patient underwent resections for PNET. The POPF rate was significantly higher in patients with PNET (24.8%) versus non-PNET (16.4%) (p < 0.0001). Male sex (OR 1.45, 95% CI 1.11–1.89), enucleation (OR 3.14, 95% CI 1.10–8.98), pancreaticoduodenectomy (OR 1.51, 95% CI 1.13–2.03), small duct size <3 mm (OR 3.24, 95% CI 1.62–6.48), and soft gland texture (OR 1.81, 95% CI 1.18–2.77) were independently associated with POPF in PNET patients on multivariable analysis. ConclusionsPOPF is more common in patients undergoing resection for PNET and is dictated primarily by surgical approach and gland characteristics.