Short- and long-term outcomes after venous resection during left-sided and total pancreatic resection: a nationwide cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Venous resection (VR) during left-sided pancreatic resection (LPR) is typically more challenging than during pancreatoduodenectomy, because the pancreatic head remains in situ. Theoretically, converting from LPR to total pancreatectomy (TP) could resolve this issue. This study compared clinical outcomes after LPR and TP with and without VR. METHODS: This nationwide retrospective study included all patients who underwent LPR for all indications or single-stage TP in the Netherlands from 2014 to 2019. RESULTS: One-thousand-seventy-five patients were analyzed: 996 underwent LPR and 79 TP. Twenty-eight (3%) LPRs were with VR (VR+), of which 17 wedge and 11 segmental resections. Of 21 (27%) TPs with VR, 11 were wedge and 10 segmental resections. In the LPR-group, VR+ was associated with a higher incidence of portomesenteric venous thrombosis (PVT) than VR- (3/28 vs. 5/968, p < 0.001), but not with major complications or mortality. Similarly, in the TP-group, higher rates of PVT were reported after VR+ (2/21 vs. 0/58, p = 0.004). The incidence of major complications and PVT were comparable between LPR-VR+ and TP-VR+, but postoperative mortality was higher in TP-VR+ (6/21 vs. 1/28 p = 0.032). CONCLUSION: Our findings suggest that, despite technical impediments of VR during LPR, switching to TP may not benefit patients.
Source: HPB
Authors: Nynke Michiels, Jenny FK Tromp, Daan J Comes, Maite NE Liem, Jesse V Groen, Marc G Besselink, Koop Bosscha, Lodewijk AA Brosens, Olivier R Busch, Marcel den Dulk, Sebastiaan Festen, Foke van Delft, Bas Groot Koerkamp, Erwin van der Harst, John Hermans, Ignace H de Hingh, Cees JHM van Laarhoven, Mike SL Liem, Eric Manusama, Vincent E de Meijer, Gijs A Patijn, Jennifer MJ Schreinemakers, Judith de Vos-Geelen, Philip R de Reuver, J Sven D Mieog, Martijn WJ Stommel
Institutions: Leiden University Medical Center, Radboud University Medical Center, Medisch Spectrum Twente, Amsterdam UMC Location University of Amsterdam, Cancer Center Amsterdam, Jeroen Bosch Ziekenhuis, University Medical Center Utrecht, Maastricht University Medical Centre, Maastricht University, OLVG, Erasmus MC, Erasmus MC Cancer Institute, Maasstad Ziekenhuis, Catharina Ziekenhuis, Medisch Centrum Leeuwarden, University Medical Center Groningen, University of Groningen, Isala, Amphia Ziekenhuis, Radboud University Nijmegen
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,100
OpenAlex ID: W4414445575