Pancreatoduodenectomy with venous or arterial resection: a NSQIP propensity score analysis

Joal D. Beane, Michael G. House, Susan C. Pitt, Ben Zarzaur, E. Molly Kilbane, Bruce L. Hall, Taylor S. Riall, Henry A. Pitt

Research output: Contribution to journalArticle

Abstract

Introduction Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. Methods Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2%) or with major venous (PD + V; 13.7%) or arterial (PD + A; 4.0%) vascular resection. Results Postoperative morbidity and mortality following PD + A (51.0% and 3.6%) was comparable to PD + V (46.9% and 3.6%) and PD (44.3 and 1.5%, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2% vs 18.1%), deep venous thromboembolism (6.9% vs 0.9%), postoperative septic shock (6.9% vs 1.7%), and length of stay (12.2 vs 10 days) while overall morbidity (45.7% vs 46.6) and mortality (1.0% vs 0%) were comparable. Conclusions Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased.

Original languageEnglish (US)
Pages (from-to)254-263
Number of pages10
JournalHPB
Volume19
Issue number3
DOIs
StatePublished - Mar 1 2017

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Beane, J. D., House, M. G., Pitt, S. C., Zarzaur, B., Kilbane, E. M., Hall, B. L., Riall, T. S., & Pitt, H. A. (2017). Pancreatoduodenectomy with venous or arterial resection: a NSQIP propensity score analysis. HPB, 19(3), 254-263. https://doi.org/10.1016/j.hpb.2016.11.013