A comprehensive study on postoperative complications and postoperative pancreatic fistula in sporadic non-functional pancreatic neuroendocrine tumors: A retrospective cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Backgrounds/Aims: Balancing surgical risks and benefits is crucial for managing non-functional pancreatic neuroendocrine tumors (NF-PNETs).Despite high postoperative pancreatic fistula (POPF) rates, studies on postoperative complications of sporadic NF-PNETs are scarce.Thus, this study aimed to investigate postoperative complications and identify risk factors for POPF.Methods: A retrospective review of 166 NF-PNET surgeries performed at Severance Hospital between February 2000 and August 2023 was conducted.Results: Age > 65 years and higher American Society of Anesthesiology (ASA) grade were not significantly correlated with severe complications (odds ratio [OR]: 1.10, p = 0.871 and OR: 1.47, p = 0.491, respectively).Surgical procedures included enucleation (13.9%), distal pancreatectomy (50.0%), central pancreatectomy (4.8%), pancreaticoduodenectomy (PD) (26.5%), and total pancreatectomy (4.8%).Severe complications occurred in 12.05% of surgeries.The overall incidence of all POPFs including biochemical leaks was 53%, while clinically relevant POPF (grade B or C) occurred in 7.8% of patients.Logistic regression showed that PD (OR: 3.94, p = 0.092) tended to be risk factor for POPF and that diameter of the main pancreatic duct (MPD) ≤ 3 mm was a significant risk factor for POPF (OR: 0.22, p = 0.008).A pancreas thickness (PT)/MPD ratio > 4.47 on preoperative computed tomography predicted all POPFs in PD patients (OR: 11.70, p = 0.001).Conclusions: Age and comorbidities had no significant impact on surgical outcomes.PD was associated with higher serious complications and POPF rates.The PT/MPD ratio is a valuable preoperative tool for predicting POPF risk in PD patients.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407555419