Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications

Bobby K. Pranger; Jacob L. van Dam; Jesse V. Groen; Casper H. van Eijck; Bas G. Koerkamp; Bert A. Bonsing; J. Sven D. Mieog; Marc G. Besselink; Olivier R. Busch; Geert Kazemier; Koert P. de Jong; Ruben H. J. de Kleine; I. Quintus Molenaar; Martijn W. J. Stommel; Michael F. Gerhards; Marielle M. E. Coolsen; Hjalmar C. van Santvoort; Erwin van der Harst; Joost M. Klaase; Vincent E. de Meijer

doi:10.1016/j.hpb.2020.10.029

Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications

Bobby K. Pranger^*, Jacob L. van Dam, Jesse V. Groen, Casper H. van Eijck, Bas G. Koerkamp, Bert A. Bonsing, J. Sven D. Mieog, Marc G. Besselink, Olivier R. Busch, Geert Kazemier, Koert P. de Jong, Ruben H. J. de Kleine, I. Quintus Molenaar, Martijn W. J. Stommel, Michael F. Gerhards, Marielle M. E. Coolsen, Hjalmar C. van Santvoort, Erwin van der Harst, Joost M. Klaase, Vincent E. de Meijer^*

^*Corresponding author for this work

Surgery

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Abstract

Background: The aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. Methods: A nationwide retrospective cohort study was performed in PAYA patients who underwent pancreatic resection between 2007 and 2016. PAYA was defined as all patients 40 years at time of surgery. Pancreatic surgery-specific complications were assessed according to international definitions and textbook outcome was determined. Results: A total of 230 patients were included in the PAYA cohort (112 distal pancreatectomies, 99 pancreatoduodenectomies), and 2526 patients in the comparator cohort. For pancreatoduodenectomy, severe morbidity (29.3% vs. 28.6%; P = 0.881), in-hospital mortality (1% vs. 4%; P = 0.179) and textbook outcome (62% vs. 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were also similar for distal pancreatectomy. After pancreatoduodenectomy, new-onset diabetes mellitus (8% vs. 16%) and exocrine pancreatic insufficiency (27% vs. 73%) were lower in the PAYA cohort when compared to adult literature. Conclusion: Pancreatic surgery-specific complications were comparable with patients 40 years. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, however, was substantially lower compared to adult literature.

Original language	English
Pages (from-to)	1175-1184
Number of pages	10
Journal	HPB
Volume	23
Issue number	8
Early online date	Aug 2021
DOIs	https://doi.org/10.1016/j.hpb.2020.10.029
Publication status	Published - Aug 2021

Bibliographical note

Funding Information:
PubMed collaborator: G.P. van der Schelling, MD, PhD (Department of Surgery, Amphia Hospital, Breda, the Netherlands).

Publisher Copyright:
© 2021 The Authors

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Pranger, B. K., van Dam, J. L., V. Groen, J., van Eijck, C. H., Koerkamp, B. G., Bonsing, B. A., Mieog, J. S. D., Besselink, M. G., Busch, O. R., Kazemier, G., de Jong, K. P., de Kleine, R. H. J., Molenaar, I. Q., Stommel, M. W. J., Gerhards, M. F., Coolsen, M. M. E., van Santvoort, H. C., van der Harst, E., Klaase, J. M., & de Meijer, V. E. (2021). Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications. HPB, 23(8), 1175-1184. https://doi.org/10.1016/j.hpb.2020.10.029

@article{bb79865146e34fa69533009227aac62c,

title = "Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications",

abstract = "Background: The aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. Methods: A nationwide retrospective cohort study was performed in PAYA patients who underwent pancreatic resection between 2007 and 2016. PAYA was defined as all patients 40 years at time of surgery. Pancreatic surgery-specific complications were assessed according to international definitions and textbook outcome was determined. Results: A total of 230 patients were included in the PAYA cohort (112 distal pancreatectomies, 99 pancreatoduodenectomies), and 2526 patients in the comparator cohort. For pancreatoduodenectomy, severe morbidity (29.3% vs. 28.6%; P = 0.881), in-hospital mortality (1% vs. 4%; P = 0.179) and textbook outcome (62% vs. 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were also similar for distal pancreatectomy. After pancreatoduodenectomy, new-onset diabetes mellitus (8% vs. 16%) and exocrine pancreatic insufficiency (27% vs. 73%) were lower in the PAYA cohort when compared to adult literature. Conclusion: Pancreatic surgery-specific complications were comparable with patients 40 years. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, however, was substantially lower compared to adult literature.",

author = "Pranger, {Bobby K.} and {van Dam}, {Jacob L.} and {V. Groen}, Jesse and {van Eijck}, {Casper H.} and Koerkamp, {Bas G.} and Bonsing, {Bert A.} and Mieog, {J. Sven D.} and Besselink, {Marc G.} and Busch, {Olivier R.} and Geert Kazemier and {de Jong}, {Koert P.} and {de Kleine}, {Ruben H. J.} and Molenaar, {I. Quintus} and Stommel, {Martijn W. J.} and Gerhards, {Michael F.} and Coolsen, {Marielle M. E.} and {van Santvoort}, {Hjalmar C.} and {van der Harst}, Erwin and Klaase, {Joost M.} and {de Meijer}, {Vincent E.}",

note = "Funding Information: PubMed collaborator: G.P. van der Schelling, MD, PhD (Department of Surgery, Amphia Hospital, Breda, the Netherlands). Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = aug,

doi = "10.1016/j.hpb.2020.10.029",

language = "English",

volume = "23",

pages = "1175--1184",

journal = "HPB",

issn = "1365-182X",

publisher = "Elsevier",

number = "8",

}

Pranger, BK, van Dam, JL, V. Groen, J, van Eijck, CH, Koerkamp, BG, Bonsing, BA, Mieog, JSD, Besselink, MG, Busch, OR, Kazemier, G, de Jong, KP, de Kleine, RHJ, Molenaar, IQ, Stommel, MWJ, Gerhards, MF, Coolsen, MME, van Santvoort, HC, van der Harst, E, Klaase, JM & de Meijer, VE 2021, 'Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications', HPB, vol. 23, no. 8, pp. 1175-1184. https://doi.org/10.1016/j.hpb.2020.10.029

TY - JOUR

T1 - Pancreatic resection in the pediatric, adolescent and young adult population

T2 - nationwide analysis on complications

AU - Pranger, Bobby K.

AU - van Dam, Jacob L.

AU - V. Groen, Jesse

AU - van Eijck, Casper H.

AU - Koerkamp, Bas G.

AU - Bonsing, Bert A.

AU - Mieog, J. Sven D.

AU - Besselink, Marc G.

AU - Busch, Olivier R.

AU - Kazemier, Geert

AU - de Jong, Koert P.

AU - de Kleine, Ruben H. J.

AU - Molenaar, I. Quintus

AU - Stommel, Martijn W. J.

AU - Gerhards, Michael F.

AU - Coolsen, Marielle M. E.

AU - van Santvoort, Hjalmar C.

AU - van der Harst, Erwin

AU - Klaase, Joost M.

AU - de Meijer, Vincent E.

PY - 2021/8

Y1 - 2021/8

N2 - Background: The aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. Methods: A nationwide retrospective cohort study was performed in PAYA patients who underwent pancreatic resection between 2007 and 2016. PAYA was defined as all patients 40 years at time of surgery. Pancreatic surgery-specific complications were assessed according to international definitions and textbook outcome was determined. Results: A total of 230 patients were included in the PAYA cohort (112 distal pancreatectomies, 99 pancreatoduodenectomies), and 2526 patients in the comparator cohort. For pancreatoduodenectomy, severe morbidity (29.3% vs. 28.6%; P = 0.881), in-hospital mortality (1% vs. 4%; P = 0.179) and textbook outcome (62% vs. 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were also similar for distal pancreatectomy. After pancreatoduodenectomy, new-onset diabetes mellitus (8% vs. 16%) and exocrine pancreatic insufficiency (27% vs. 73%) were lower in the PAYA cohort when compared to adult literature. Conclusion: Pancreatic surgery-specific complications were comparable with patients 40 years. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, however, was substantially lower compared to adult literature.

AB - Background: The aim of this study was to determine pancreatic surgery specific short- and long-term complications of pediatric, adolescent and young adult (PAYA) patients who underwent pancreatic resection, as compared to a comparator cohort of adults. Methods: A nationwide retrospective cohort study was performed in PAYA patients who underwent pancreatic resection between 2007 and 2016. PAYA was defined as all patients 40 years at time of surgery. Pancreatic surgery-specific complications were assessed according to international definitions and textbook outcome was determined. Results: A total of 230 patients were included in the PAYA cohort (112 distal pancreatectomies, 99 pancreatoduodenectomies), and 2526 patients in the comparator cohort. For pancreatoduodenectomy, severe morbidity (29.3% vs. 28.6%; P = 0.881), in-hospital mortality (1% vs. 4%; P = 0.179) and textbook outcome (62% vs. 58%; P = 0.572) were comparable between the PAYA and the comparator cohort. These outcomes were also similar for distal pancreatectomy. After pancreatoduodenectomy, new-onset diabetes mellitus (8% vs. 16%) and exocrine pancreatic insufficiency (27% vs. 73%) were lower in the PAYA cohort when compared to adult literature. Conclusion: Pancreatic surgery-specific complications were comparable with patients 40 years. Development of endocrine and exocrine insufficiency in PAYA patients who underwent pancreatoduodenectomy, however, was substantially lower compared to adult literature.

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U2 - 10.1016/j.hpb.2020.10.029

DO - 10.1016/j.hpb.2020.10.029

M3 - Article

C2 - 33281080

AN - SCOPUS:85097253979

SN - 1365-182X

VL - 23

SP - 1175

EP - 1184

JO - HPB

JF - HPB

IS - 8

ER -

Pancreatic resection in the pediatric, adolescent and young adult population: nationwide analysis on complications

Abstract

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