Thirty-day outcomes underestimate endocrine and exocrine insufficiency after pancreatic resection

Pei Wen Lim, Kate H. Dinh, Mary Sullivan, Wahid Y. Wassef, Jaroslav Zivny, Giles F. Whalen, Jennifer LaFemina

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background Long-term incidence of endocrine and exocrine insufficiency after pancreatectomy is poorly described. We analyze the long-term risks of pancreatic insufficiency after pancreatectomy. Methods Subjects who underwent pancreatectomy from 2002 to 2012 were identified from a prospective database (n = 227). Subjects who underwent total pancreatectomy or pancreatitis surgery were excluded. New post-operative endocrine and exocrine insufficiency was defined as the need for new pharmacologic intervention within 1000 days from resection. Results 28 (16%) of 178 subjects without pre-existing endocrine insufficiency developed post-operative endocrine insufficiency: 7 (25%) did so within 30 days, 8 (29%) between 30 and 90 days, and 13 (46%) after 90 days. 94 (43%) of 214 subjects without pre-operative exocrine insufficiency developed exocrine insufficiency: 20 (21%) did so within 30 days, 29 (31%) between 30 and 90 days, and 45 (48%) after 90 days. Adjuvant radiation was associated with new endocrine insufficiency. On multivariate regression, pancreaticoduodenectomy and chemotherapy were associated with a greater risk of exocrine insufficiency. Conclusion Reporting 30-day functional outcomes for pancreatic resection is insufficient, as nearly 45% of subjects who develop disease do so after 90 days. Reporting of at least 90-day outcomes may more reliably assess risk for post-operative endocrine and exocrine insufficiency.

Original languageEnglish (US)
Pages (from-to)360-366
Number of pages7
JournalHPB
Volume18
Issue number4
DOIs
StatePublished - 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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