Academic Journal
Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple’s (RAW) study
| العنوان: | Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple’s (RAW) study |
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| المؤلفون: | Russell, T.B., Labib, P.L., Denson, J., Streeter, A., Ausania, F., Pando, E., Roberts, K.J., Kausar, A., Mavroeidis, V.K., Marangoni, G., Thomasset, S.C., Frampton, A.E., Lykoudis, P., Maglione, M., Alhaboob, N., Bari, H., Smith, A.M., Spalding, D., Srinivasan, P., Davidson, B.R., Bhogal, R.H., Croagh, D., Dominguez, I., Thakkar, R., Gomez, D., Silva, M.A., Lapolla, P., Mingoli, A., Porcu, A., Shah, N.S., Hamady, Z.Z.R., Al-Sarrieh, B.A., Serrablo, A., Aroori, S., Sheridan, D., Puckett, M., Browning, M.G., Gonzalez-Abos, C., Fernandes, N., Moller, E.G., Taboada, C.D., Pande, R., Alfarah, J., Bandyopadhyay, S., Abdelrahim, A., Khan, A., Jordan, C., Rees, J.R.E., Blege, H., Cambridge, W., White, O., Blacker, S., Blackburn, J., Sweeney, C., Field, D., Gouda, M., Bellotti, R., Hamid, H.K.S., Ahmed, H., Moriarty, C., White, L., Priestley, M., Bode, K., Sharp, J., Wragg, R., Jackson, B., Craven, S., Fehervari, M., Pai, M., Alghazawi, L., Onifade, A., Ribaud, J., Nair, A., Mariathasan, M., Grayson, N., Pericleous, S., Patel, K., Shaw, C., Morare, N., Zaban, M.K., Doyle, J., Guerrero, A., Moguel, A., Chan, C., Jones, M., Buckley, E., Akter, N., Treherne, K., Gordon, G., Hughes, D., Urbonas, T., Brachini, G., Caronna, R., Chirletti, P., Perra, T., Kahar, N.N.A., Hall, T., Nadeem, N., Karar, S., Arshad, A., Al-Sarrieh, B., Yarwood, A., Hammoda, M., Artigas, M., Paterna-López, S. |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2023 |
| المجموعة: | White Rose Research Online (Universities of Leeds, Sheffield & York) |
| الوصف: | Background Pancreatoduodenectomy (PD) is associated with significant postoperative morbidity. Surgeons should have a sound understanding of the potential complications for consenting and benchmarking purposes. Furthermore, preoperative identification of high-risk patients can guide patient selection and potentially allow for targeted prehabilitation and/or individualized treatment regimens. Using a large multicentre cohort, this study aimed to calculate the incidence of all PD complications and identify risk factors. Method Data were extracted from the Recurrence After Whipple’s (RAW) study, a retrospective cohort study of PD outcomes (29 centres from 8 countries, 2012–2015). The incidence and severity of all complications was recorded and potential risk factors for morbidity, major morbidity (Clavien–Dindo grade > IIIa), postoperative pancreatic fistula (POPF), post-pancreatectomy haemorrhage (PPH) and 90-day mortality were investigated. Results Among the 1348 included patients, overall morbidity, major morbidity, POPF, PPH and perioperative death affected 53 per cent (n = 720), 17 per cent (n = 228), 8 per cent (n = 108), 6 per cent (n = 84) and 4 per cent (n = 53), respectively. Following multivariable tests, a high BMI (P = 0.007), an ASA grade > II (P < 0.0001) and a classic Whipple approach (P = 0.005) were all associated with increased overall morbidity. In addition, ASA grade > II patients were at increased risk of major morbidity (P < 0.0001), and a raised BMI correlated with a greater risk of POPF (P = 0.001). Conclusion In this multicentre study of PD outcomes, an ASA grade > II was a risk factor for major morbidity and a high BMI was a risk factor for POPF. Patients who are preoperatively identified to be high risk may benefit from targeted prehabilitation or individualized treatment regimens. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| Relation: | https://eprints.whiterose.ac.uk/207101/1/zrad106.pdf; Russell, T.B. orcid.org/0000-0001-6836-3746 , Labib, P.L., Denson, J. et al. (136 more authors) (2023) Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple’s (RAW) study. BJS Open, 7 (6). zrad106. ISSN 2474-9842 |
| DOI: | 10.1093/bjsopen/zrad106 |
| الاتاحة: | https://eprints.whiterose.ac.uk/207101/ https://eprints.whiterose.ac.uk/207101/1/zrad106.pdf https://doi.org/10.1093/bjsopen/zrad106 |
| Rights: | cc_by_nc_4 |
| رقم الانضمام: | edsbas.49E4825A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/bjsopen/zrad106 |
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