BACKGROUND: The standard treatment for ampullary adenocarcinoma is pancreaticoduodenectomy. Identification of preoperative risk factors might help the clinician to select patients fit for resection and potentially decrease morbidity and mortality after PD. We conducted a cohort study to determine the preoperative factors related to 90-day severe morbidity and mortality after PD. METHODS: We conducted a retrospective cohort study in patients with a diagnosis of ampullary adenocarcinoma who underwent an open PD between January 2010 and December 2019 at our tertiary centre. RESULTS: Independent preoperative predictors of mortality were the albumin-bilirubin (ALBI) grade 3 (OR: 21.7; CI 95: 2.1-226.9; p=0.01) and the estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 (OR: 17.7; CI 95: 1.8-172.6; p=0.013). The eGFR <90 mL/min/1.73 m2 (OR = 6.6; CI 95: 1.9-23.4; p=0.003) and prothrombin time (OR = 1.5; CI 95; 1.1-2.1; p=0.005) were independent predictors for severe morbidity. CONCLUSION: These findings suggest that baseline renal function measured by the eGFR and liver function categorized with the ALBI grading are predictors of severe morbidity and mortality. Thus, they should be considered when selecting patients for PD or the use of neoadjuvant treatments. Further research is warranted.
BACKGROUND: The standard treatment for ampullary adenocarcinoma is pancreaticoduodenectomy. Identification of preoperative risk factors might help the clinician to select patients fit for resection and potentially decrease morbidity and mortality after PD. We conducted a cohort study to determine the preoperative factors related to 90-day severe morbidity and mortality after PD. METHODS: We conducted a retrospective cohort study in patients with a diagnosis of ampullary adenocarcinoma who underwent an open PD between January 2010 and December 2019 at our tertiary centre. RESULTS: Independent preoperative predictors of mortality were the albumin-bilirubin (ALBI) grade 3 (OR: 21.7; CI 95: 2.1-226.9; p=0.01) and the estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 (OR: 17.7; CI 95: 1.8-172.6; p=0.013). The eGFR <90 mL/min/1.73 m2 (OR = 6.6; CI 95: 1.9-23.4; p=0.003) and prothrombin time (OR = 1.5; CI 95; 1.1-2.1; p=0.005) were independent predictors for severe morbidity. CONCLUSION: These findings suggest that baseline renal function measured by the eGFR and liver function categorized with the ALBI grading are predictors of severe morbidity and mortality. Thus, they should be considered when selecting patients for PD or the use of neoadjuvant treatments. Further research is warranted.
Authors: Claudio Bassi; Giovanni Marchegiani; Christos Dervenis; Micheal Sarr; Mohammad Abu Hilal; Mustapha Adham; Peter Allen; Roland Andersson; Horacio J Asbun; Marc G Besselink; Kevin Conlon; Marco Del Chiaro; Massimo Falconi; Laureano Fernandez-Cruz; Carlos Fernandez-Del Castillo; Abe Fingerhut; Helmut Friess; Dirk J Gouma; Thilo Hackert; Jakob Izbicki; Keith D Lillemoe; John P Neoptolemos; Attila Olah; Richard Schulick; Shailesh V Shrikhande; Tadahiro Takada; Kyoichi Takaori; William Traverso; Charles R Vollmer; Christopher L Wolfgang; Charles J Yeo; Roberto Salvia; Marcus Buchler Journal: Surgery Date: 2016-12-28 Impact factor: 3.982
Authors: Brett L Ecker; Matthew T McMillan; Laura Maggino; Valentina Allegrini; Horacio J Asbun; Chad G Ball; Claudio Bassi; Joal D Beane; Stephen W Behrman; Adam C Berger; Mark Bloomston; Mark P Callery; John D Christein; Euan Dickson; Elijah Dixon; Jeffrey A Drebin; Carlos Fernandez-Del Castillo; William E Fisher; Zhi Ven Fong; Ericka Haverick; Robert H Hollis; Michael G House; Steven J Hughes; Nigel B Jamieson; Tara S Kent; Stacy J Kowalsky; John W Kunstman; Giuseppe Malleo; Ronald R Salem; Kevin C Soares; Vicente Valero; Ammara A Watkins; Christopher L Wolfgang; Amer H Zureikat; Charles M Vollmer Journal: J Gastrointest Surg Date: 2017-08-24 Impact factor: 3.452
Authors: Patricia Sánchez-Velázquez; Xavier Muller; Giuseppe Malleo; Joon-Seong Park; Ho-Kyoung Hwang; Niccolò Napoli; Ammar A Javed; Yosuke Inoue; Nassiba Beghdadi; Marit Kalisvaart; Emanuel Vigia; Carrie D Walsh; Brendan Lovasik; Juli Busquets; Chiara Scandavini; Fabien Robin; Hideyuki Yoshitomi; Tara M Mackay; Olivier R Busch; Hermien Hartog; Stefan Heinrich; Ana Gleisner; Julie Perinel; Michael Passeri; Nuria Lluis; Dimitri A Raptis; Christoph Tschuor; Christian E Oberkofler; Michelle L DeOliveira; Henrik Petrowsky; John Martinie; Horacio Asbun; Mustapha Adham; Richard Schulick; Hauke Lang; Bas Groot Koerkamp; Marc G Besselink; Ho-Seong Han; Masaru Miyazaki; Cristina R Ferrone; Carlos Fernández-Del Castillo; Keith D Lillemoe; Laurent Sulpice; Karim Boudjema; Marco Del Chiaro; Joan Fabregat; David A Kooby; Peter Allen; Harish Lavu; Charles J Yeo; Eduardo Barroso; Keith Roberts; Paolo Muiesan; Alain Sauvanet; Akio Saiura; Christopher L Wolfgang; John L Cameron; Ugo Boggi; Dong-Sup Yoon; Claudio Bassi; Milo A Puhan; Pierre-Alain Clavien Journal: Ann Surg Date: 2019-08 Impact factor: 12.969
Authors: Malcolm H Squires; Vishes V Mehta; Sarah B Fisher; Neha L Lad; David A Kooby; Juan M Sarmiento; Kenneth Cardona; Maria C Russell; Charles A Staley; Shishir K Maithel Journal: J Am Coll Surg Date: 2013-11-07 Impact factor: 6.113