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Background: Pancreatic resection with concomitant vascular resection is increasingly practiced with outcomes mainly reported from specialist centers but lacking results from prospective global data. This study aimed to investigate factors associated with short-term outcomes after vascular resections in pancreatic surgery worldwide. Patients and Methods: Data were extracted from a prospective, multicenter, international cross-sectional snapshot study in 2021 (pancreasgroup.org) assessing short-term outcomes after pancreatic surgery worldwide (NCT04652271). In the patient cohort of pancreatic surgery with simultaneous vascular resection for various diseases, short-term outcomes were reported and compared with established benchmark values. Factors affecting major complications, mortality, and histopathological resection status were assessed in multivariable logistic regression analyses with interaction testing. Results: From a total of 3926 patients undergoing pancreatic surgery, 565 had associated vascular resections, of which 444 had venous resections alone and 121 had arterial resections alone or with concomitant venous resection. Of the 153 (47%) benchmark cases with pancreatoduodenectomy and venous resection, median postoperative morbidity fell within established benchmark criteria. Median 90-day major complication and mortality rates were similar in pancreatic resection with venous, arterial or no vascular resections (45 and 10%, 47 and 6.6%, 42 and 9.6% respectively). Patients undergoing arterial resections that developed a clinically relevant pancreatic fistula faced substantially elevated odds of 90-day mortality (OR 8.8 CI 1.6–48). In pancreatic ductal adenocarcinoma, the R1 rate was 26%, neoadjuvant chemotherapy being protective for both overall and venous-specific margins. Conclusions: Vascular pancreatic surgery is performed across diverse healthcare settings worldwide. While perioperative complications were comparable to nonvascular pancreatic resections, the observed 90-day mortality was considerable overall. International collaborative efforts should focus on understanding practice variations and improve accessibility of optimal perioperative care to promote rescue capabilities.
Analysis of Short-Term Outcomes in Pancreatic Surgery with Vascular Resection from a Prospective Multicenter Global Study
Tinguely P.;Hidalgo Salinas C.;Staubli S. M.;Raptis D. A.;Fusai G. K.;Wolfgang C.;Smith M.;Siriwardena A.;Shrikhande S. V.;Harrison E.;Hackert T.;Falconi M.;Dervenis C.;Del Chiaro M.;Davidson B.;Conlon K.;Besselink M.;Bassi C.;Hilal M. A.;Zachiotis M.;Wei A.;Tamburrino D.;Soggiu F.;Schnitzbauer A. A.;de Santibanes M.;Velazquez P. S.;Ravikumar R.;Passas I.;Oberkofler C.;Oba A.;Marchegiani G.;Machairas N.;Balci D.;Borakati A.;Chihaka O.;Al-Naggar H.;Ganai S.;Qadan M.;Giorgakis E.;Iype S.;Jamieson N.;Taylor M.;Coker A.;Baraket O.;Houssem A.;Jen P. -C. Y. F.;Wu C. H.;Chaaban M. K.;Tishreen A. H.;Kuemmerli C.;Gloor B.;Cristaudi A.;Sandstrom P.;Abdelmageed A.;Ielpo B.;Omoshoro-Jones J.;Trotovsek B.;Goh B.;Galun D.;Karamarkovic A.;Barbu S.;Polkowski W.;Pedziwiatr M.;The C.;Alnammourah W. M.;Amro S.;Jayyab M. A.;Ullah S.;Alatise O.;Adeyeye A.;Koea J.;Nashidengo P.;Benkabbou A.;Erdene S.;Melchor-Ruan J.;Padilla A. E.;Ghani S.;Bong J.;Dulskas A.;Elhadi M.;Khalife M.;Han H. -S.;Mohsen M.;Obeidat K.;Satoi S.;Al-Sader M. A. -J.;Hashim H. T.;Prabowo E.;Misra S.;Papaziogas V.;Felekouras E.;Stavrou G.;Lupinacci R.;Sulpice L.;Huhta H.;Tammik O.;Saad M.;Fathallah D.;Nikov A.;Gouvas N.;Mikulic D.;Hendi M.;Wei K.;Devaud N.;Diaz C.;Martin J.;Tang E.;Fabrice B.;Belev N.;Torres O.;Coelho G.;Sergeant G.;Shcherba A.;Nikfarjam M.;Kacimi S. E.;Bentabak K.;Al-Saban R.;Al-Eryani F.;Albar A.;Martins P.;Sham J.;Bowne W.;Lavu H.;Lamm R.;Schrope B.;Nigh J.;Hardgrave H.;Osborn T.;Krinock D.;Spencer-Cole R.;Gnerlich J.;Moris D.;Thompson R.;Nebbia M.;Clancy T.;Sulciner M.;Mortimer M.;Russell T.;Ceresa C.;Patel K.;Sanjay P.;Gareb F.;Carino N. D. L.;Khalil A.;Kocher H.;Tinguely P.;Mohamed A.;Lim W.;Skipworth J.;Sumarokova V.;Kvasivka O.;Kopchak K.;Skoryi D.;Colak E.;Atici S. D.;Sert I.;Ulgur H.;Atici A. E.;Hanefa F.;Aydin H.;Gumusoglu A.;Aday U.;Bayhan H.;Kerem M.;Tez M.;Kchaou A.;Bouaziz H.;Yu M. -C.;Hamdan A.;Hassan B. H.;Suliman A.;Al Houri H.;Alhouri A.;Abdulmonem A.;Al-Abed O.;Azizeh O.;Kayali A.;Douba Z.;Alhashemi M.;Jonas J. P.;Gutknecht S.;Schmidt J.;Abbassi F.;Moeckli B.;Sparrelid E.;Andersson B.;Williamsson C.;Tingstedt B.;Lundgren L.;Hamid H.;Serrablo A.;Rodriguez-Lopez M.;Dorcaratto D.;Ibanez C. B.;Pozo C. D. -D.;Domingo M. G.;Vera V.;Munoz-Bellvis L.;Rotellar F.;Segura-Sampedro J. J.;Garcia L. S.;Suarez-Munoz M. A.;Di Martino M.;Dziakova J.;Justo I.;Busquets J.;Al Shwely F.;Falgueras L.;Ruiz P.;Santos E. P.;Arnau A. B. M.;Ausania F.;Del Mar Rico-Morales M.;Ramia J.;Marcello M.;Loots E.;Protic M.;Juloski J.;Bezmarevic M.;Arbutina D.;Kmezic S.;Bogdanovic A.;Alharthi M.;Gachabayov M.;Drozdov E.;Kuchin D.;Kaldarov A.;Bagmet N.;Bedzhanyan A.;Semenenko I.;Litvin A.;Mizgirev D.;Belyaev A.;Velenciuc N.;Musina A. -M.;Matei S.;Bodea R.;Bartos A.;Petrea S.;Brezean I.;Ginghina O.;Mardare M.;Dumitrascu T.;Radulescu R. B.;Vigia E.;Kornasiewicz O.;Korcz W.;Szwedziak K.;Szewczyk P.;Grzasiak O.;Ciesielski W.;Sierzega M.;Rymarowicz J.;Flisinska M.;Alfonso C.;Teh C.;Coayla G.;Hammoudeh A.;Manasrah F.;Titi R.;Zreqat Q.;Asghar M.;Siddiqui T.;Abbasy J.;Welsh F.;Gunawardene A.;Cross A.;Bindra V.;Johnston P.;Chu M. J. J.;Windsor J.;Lakhey P. J.;Nashidengo A. P.;Majbar M. A.;Echiguer S.;Elhassouni R.;Zentar A.;Serji B.;Gouazar I.;Korch M.;Zorrilla C. F.;Chik I.;Zakaria A. D.;Rosso E.;Kvietkauskas M.;Mikutaitis V.;Slepavicius A.;Jurgaitis J.;Eismontas V.;Vanagas T.;Alharari M.;Abdulwahed E.;Khalil W.;Salem O.;Gerwash A.;Othman E.;Ahmeed Ahmeed S.;Alshareea E.;Binnawara M.;Morgom M.;Burgan D.;Younes E.;Benamwor A.;Alshatshat A.;Alowjali F.;Faraj W.;Atstupens K.;Fakhradiyev I.;Khamees A.;Al-Samawi A.;Shumrakh S.;Alsabah M.;Al-Shami K.;Rababa H.;Obed A.;Alissawi S.;Tanabe M.;Maehira H.;Matsumoto I.;Hashimoto D.;Frontali A.;Napetti S.;Conci S.;Campagnaro T.;Ruzzenente A.;Querini G.;Intini S.;Ferrero A.;Novello S.;Ciarleglio F.;Perra T.;Feo C.;Porcu A.;Manzia T. M.;Coppola A.;Giuliante F.;Pinotti E.;Kauffmann E. F.;Morelli L.;Regi P.;Cobianchi L.;Giuffrida M.;Tolin F.;Moletta L.;Belli A.;Rompianesi G.;Iacomino A.;Uggeri F.;Di Benedetto F.;Stella M.;Baldi C.;Zerbi A.;Mazzaferro V.;Mazzola M.;Recordare A.;Saladino E.;D'Ugo S.;De Rosa R.;Carganico G.;Pacilio C. A.;D'Acapito F.;Nelli T.;Bencini L.;Testa V.;Sasia D.;Antonucci A.;Papa M. V.;Ciola M.;Andriola V.;Vivarelli M.;Sadot E.;Al-Juaifari M.;Kumar T.;S I.;Bansal V.;Velagala J. R.;Chattopadhyay S.;Das K.;Varshney V.;Vishnoi J. R.;Jain S.;Yadav K.;Gupta R.;Purushothaman G.;Karuparthi S.;Vereczkei A.;Bursics A.;Petras P.;Nutinas A.;Katsourakis A.;Giakoustidis D.;Kontis E.;Mulita F.;Christodoulidis G.;Magouliotis D.;Glantzounis G.;Fradelos E.;Korkolis D.;Bramis K.;Vezakis A.;Toutouzas K.;Fragulidis G.;Polydorou A.;Papalampros A.;Schizas D.;Tzimas G.;Dorovinis P.;Tomara N.;Sotiropoulou M.;Stergiou D.;Vassiliu P.;Kokoropoulos P.;Michalopoulos N.;Papakonstantinou D.;Arkadopoulos N.;Ioannidis A.;Kechagias A.;Tsoukalas N.;Makridis G.;Nadalin S.;Kardassis D.;Struecker B.;Izbicki J.;Uzunoglu F.;Scognamiglio P.;Wagner K.;Reese T.;Ronellenfitsch U.;Gaedcke J.;Reichert M.;Mazzella E.;Brunner M.;Korn S.;Praetorius C.;Bulian D.;Belyaev O.;Pozios I.;Bartella I.;Demetrashvili Z.;Giannone F.;Schwarz L.;Anyla M.;Goasguen N.;Gaujoux S.;Savala N.;Souche F. -R.;Dupre A.;Piessen G.;Truant S.;Brustia R.;Nortunen M.;Kauppila J.;Alsabbagh F.;Omar M.;Awad S.;Monier A.;Shehta A.;Metwally I.;Nagy M.;Alazab E.;Abdelmawgoud S.;Awad A. K.;Fahim A.;Gobran M.;Diab S.;Sayed H.;Abdelkarem M.;Salah M.;Farag M.;Mansour A.;Abdelalemm M.;Nafea A.;Hamouda M.;Moneam M. A. E.;Ealreibi H.;Tanas Y.;Elkeleny M.;Mourad M.;Alboridy M.;Tayiawi M.;Attalla A.;Zaruba P.;Lovecek M.;Bubalo T.;Stironja I.;Chen Y.;Cai L.;Branes A.;Diaz C.;Serrano P.;Kostov D.;Nikolaev E.;Mihaylov V.;Vladov N.;Takorov I.;Slavchev M.;Krastev P.;Sampaio A.;Marques N.;Rodrigues P.;Militz M.;Pinto R.;Strypstein S.;Berrevoet F.;Gryspeerdt F.;Hartman V.;Van den Bossche B.;Stoyanova R.;Kornprat P.;Apostolou C.;Ng Z. Q.;Burnett D.;Chen S.;Shah K.;Chong L.;Rowcroft A.;Hodgson R.;Hall K.;Gananadha S.;Joglekar S.;Schelotto P. B.;de Santibanes M.;Mc Cormack L.;Ouyahia A.;Abdoun M.;Rais M.;Bouaoud S.;Ouahab I.;Tidjane A.;Behi A. E.
2025
Abstract
Background: Pancreatic resection with concomitant vascular resection is increasingly practiced with outcomes mainly reported from specialist centers but lacking results from prospective global data. This study aimed to investigate factors associated with short-term outcomes after vascular resections in pancreatic surgery worldwide. Patients and Methods: Data were extracted from a prospective, multicenter, international cross-sectional snapshot study in 2021 (pancreasgroup.org) assessing short-term outcomes after pancreatic surgery worldwide (NCT04652271). In the patient cohort of pancreatic surgery with simultaneous vascular resection for various diseases, short-term outcomes were reported and compared with established benchmark values. Factors affecting major complications, mortality, and histopathological resection status were assessed in multivariable logistic regression analyses with interaction testing. Results: From a total of 3926 patients undergoing pancreatic surgery, 565 had associated vascular resections, of which 444 had venous resections alone and 121 had arterial resections alone or with concomitant venous resection. Of the 153 (47%) benchmark cases with pancreatoduodenectomy and venous resection, median postoperative morbidity fell within established benchmark criteria. Median 90-day major complication and mortality rates were similar in pancreatic resection with venous, arterial or no vascular resections (45 and 10%, 47 and 6.6%, 42 and 9.6% respectively). Patients undergoing arterial resections that developed a clinically relevant pancreatic fistula faced substantially elevated odds of 90-day mortality (OR 8.8 CI 1.6–48). In pancreatic ductal adenocarcinoma, the R1 rate was 26%, neoadjuvant chemotherapy being protective for both overall and venous-specific margins. Conclusions: Vascular pancreatic surgery is performed across diverse healthcare settings worldwide. While perioperative complications were comparable to nonvascular pancreatic resections, the observed 90-day mortality was considerable overall. International collaborative efforts should focus on understanding practice variations and improve accessibility of optimal perioperative care to promote rescue capabilities.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3566858
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
