Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 116] A Comprehensive Study on Postoperative Complications And POPF in Sporadic Non-Functional Pancreatic Neuroendocrine Tumors: a Retrospective Cohort Study
Juwan KIM 1, Seung Soo HONG 2, Sung Hyun KIM 2, Ho Kyong HWANG 2, Chang Moo KANG 2
1 Division of Hepatobiliary And Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea , Severance Hospital, REPUBLIC OF KOREA, 2 Department of Surgery , Severance Hospital, REPUBLIC OF KOREA
Background : Balancing surgical risks and benefits is essential in treating Nonfunctional pancreatic neuroendocrine tumors (NF-PNETs). Despite a known higher incidence of postoperative pancreatic fistula (POPF) in PNETs, research on sporadic NF-PNETs postoperative complications is limited. This study aims to fill this gap by evaluating complications and identifying risk factors for POPF.
Methods : We conducted a comprehensive retrospective review of 166 patients with NF-PNET who underwent surgery at Severance Hospital, Seoul, from February 2000 to August 2023.
Results : The surgeries comprised enucleation (13.9%), Distal Pancreatectomy (DP) (50%), Central Pancreatectomy (CP) (4.8%), Pancreaticoduodenectomy (PD) (26.5%), and Total Pancreatectomy (TP) (4.8%). Severe complications occurred in 12.05% of cases. The overall incidence of POPF was high at 53%, with clinically relevant (grade B or C) POPF observed in 7.8% of patients. Notably, a soft pancreatic texture was prevalent in 93% of cases, and 89.6% had a Main Pancreatic Duct (MPD) diameter ≤3mm. Logistic regression analysis highlighted PD and MPD diameter >3mm as significant risk factors for POPF (OR=3.94, p=0.092; OR=0.22, p=0.008). A ratio of pancreatic thickness to MPD diameter (PT/MPD ratio) >4.47, determined via preoperative CT, emerged as a potent predictor of POPF risk in patient who underwent PD (OR=11.70, p=0.001).
Conclusions : Our findings suggest that age and comorbidities do not significantly influence surgical outcomes in NF-PNET patients. PD, particularly, showed a higher tendency for serious complications an POPF. The PT/MPD ratio serves as a critical tool in preoperative assessment, enhancing the prediction and management of POPF risks in patient who underwent PD.
Methods : We conducted a comprehensive retrospective review of 166 patients with NF-PNET who underwent surgery at Severance Hospital, Seoul, from February 2000 to August 2023.
Results : The surgeries comprised enucleation (13.9%), Distal Pancreatectomy (DP) (50%), Central Pancreatectomy (CP) (4.8%), Pancreaticoduodenectomy (PD) (26.5%), and Total Pancreatectomy (TP) (4.8%). Severe complications occurred in 12.05% of cases. The overall incidence of POPF was high at 53%, with clinically relevant (grade B or C) POPF observed in 7.8% of patients. Notably, a soft pancreatic texture was prevalent in 93% of cases, and 89.6% had a Main Pancreatic Duct (MPD) diameter ≤3mm. Logistic regression analysis highlighted PD and MPD diameter >3mm as significant risk factors for POPF (OR=3.94, p=0.092; OR=0.22, p=0.008). A ratio of pancreatic thickness to MPD diameter (PT/MPD ratio) >4.47, determined via preoperative CT, emerged as a potent predictor of POPF risk in patient who underwent PD (OR=11.70, p=0.001).
Conclusions : Our findings suggest that age and comorbidities do not significantly influence surgical outcomes in NF-PNET patients. PD, particularly, showed a higher tendency for serious complications an POPF. The PT/MPD ratio serves as a critical tool in preoperative assessment, enhancing the prediction and management of POPF risks in patient who underwent PD.
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E-poster
E-Session 03/21 ALL DAY