Pancreatic fistulae after pancreatic resections for neuroendocrine tumours compared with resections for other lesions

HPB (Oxford). 2015 Jan;17(1):38-45. doi: 10.1111/hpb.12319. Epub 2014 Jul 18.

Abstract

Background: Resection for pancreatic neuroendocrine tumours (PNET) is suggested to be associated with an increased risk of a post-operative pancreatic fistula (POPF). The aim of this study was to describe morbidity after resections for PNET, focusing on POPF. Outcomes were compared with resections for other lesions.

Methods: Patients undergoing an elective pancreatic resection during a 12-year period were retrospectively analysed. Morbidity was defined according to the International Study Group of Pancreatic Surgery (ISGPS) definitions.

Results: Eighty-eight out of 832 patients (10.6%) underwent a resection for PNET. Atypical pancreatic resections (enucleation and central pancreatectomy) and distal pancreatectomies were more frequently performed for PNET. The POPF rate was 22.7% in patients operated for PNET compared with 17.2% in other patients (P = 0.200). In univariate analysis, body mass index (BMI), pancreatic duct diameter, somatostatin analogue administration, type of resection and type of pathology were associated with a POPF. In multivariate analysis, BMI, a pancreatic duct diameter <3 mm and central pancreatectomy remained independent risk factors [odds ratio (OR) 1.93, 95% confidence interval (CI) 1.22-3.07 and OR 3.04, 95% CI 1.05-8.82, respectively].

Conclusions: High rates of POPF were found in patients operated for PNET. However, this was mainly owing to the fact that atypical resections, known to be associated with a higher fistula rate, were performed more frequently in these patients.

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Odds Ratio
  • Pancreatectomy / adverse effects*
  • Pancreatic Fistula / diagnosis
  • Pancreatic Fistula / etiology*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome