Impact of pulmonary embolism on morbidity and mortality in patients undergoing pancreatic surgery.
Deep venous thrombosis
Pancreatic surgery
Pulmonary embolism
Venous thromboembolism
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
19
08
2020
accepted:
02
10
2020
pubmed:
11
10
2020
medline:
25
9
2021
entrez:
10
10
2020
Statut:
ppublish
Résumé
Postoperative pulmonary embolism (PE) after pancreatic surgery is a potentially life-threatening complication. However, the magnitude of morbidity and mortality of PE is still uncertain. The present study aims to assess the incidence of PE after pancreatic surgery and analyze its impact on the outcome. We conducted a retrospective study including all patients who underwent pancreatic resections between 2005 and 2017. The development of PE was analyzed for a 90-day period following surgery. Risk factors were evaluated using regression models. The study investigated 947 patients undergoing pancreatic surgery. Overall, 26 (2.7%) patients developed PE. The median body mass index (BMI) of patients with PE was significantly higher (28.1 kg/m Patients with increased BMI, a history of deep venous thrombosis, and multivisceral resections are a high-risk group for PE after pancreatic surgery. While the absolute incidence and related mortality of PE after pancreatic surgery is low, it is associated with severe sequelae.
Identifiants
pubmed: 33037463
doi: 10.1007/s00423-020-02009-4
pii: 10.1007/s00423-020-02009-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
893-902Références
DeOliveira ML, Winter JM, Schafer M et al (2006) Assessment of complications after pancreatic surgery: a novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg 244(6):931–937 discussion 937–939
pubmed: 17122618
pmcid: 1856636
Kamphues C, Bova R, Schricke D et al (2012) Postoperative complications deteriorate long-term outcome in pancreatic cancer patients. Ann Surg Oncol 19(3):856–863
pubmed: 21879265
Hata T, Motoi F, Ishida M et al (2016) Effect of hospital volume on surgical outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis. Ann Surg 263(4):664–672
pubmed: 26636243
Hartwig W, Hackert T, Hinz U et al (2009) Multivisceral resection for pancreatic malignancies: risk-analysis and long-term outcome. Ann Surg 250(1):81–87
pubmed: 19561478
Anderson FA Jr, Spencer FA (2003) Risk factors for venous thromboembolism. Circulation 107(23 Suppl 1):l9–l16
Lindblad B, Sternby NH, Bergqvist D (1991) Incidence of venous thromboembolism verified by necropsy over 30 years. BMJ. 302(6778):709–711
pubmed: 2021744
pmcid: 1669118
Alikhan R, Peters F, Wilmott R et al (2004) Fatal pulmonary embolism in hospitalised patients: a necropsy review. J Clin Pathol 57(12):1254–1257
pubmed: 15563663
pmcid: 1770519
Barber EL, Clarke-Pearson DL (2017) Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecol Oncol 144(2):420–427
pubmed: 27890280
Furie B, Furie BC (2008) Mechanisms of thrombus formation. N Engl J Med 359(9):938–949
pubmed: 18753650
Hwang HK, Kim H, Kang CM et al (2012) Serous cyst adenoma of the pancreas: appraisal of active surgical strategy before it causes problems. Surg Endosc 26(6):1560–1565
pubmed: 22179458
Bergqvist D (2006) Venous thromboembolism: a review of risk and prevention in colorectal surgery patients. Dis Colon Rectum 49(10):1620–1628
pubmed: 17019655
Qadan M, Polk HC Jr, Hohmann SF et al (2011) A reassessment of needs and practice patterns in pharmacologic prophylaxis of venous thromboembolism following elective major surgery. Ann Surg 253(2):215–220
pubmed: 21245667
Agnelli G, Bolis G, Capussotti L et al (2006) A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project. Ann Surg 243(1):89–95
pubmed: 16371741
pmcid: 1449979
Nguyen NT, Hinojosa MW, Fayad C et al (2007) Laparoscopic surgery is associated with a lower incidence of venous thromboembolism compared with open surgery. Ann Surg 246(6):1021–1027
pubmed: 18043105
Molena D, Mungo B, Stem M et al (2015) Prevalence, impact, and risk factors for hospital-acquired conditions after major surgical resection for cancer: a NSQIP analysis. J Gastrointest Surg 19(1):142–151 discussion 151
pubmed: 25199948
Tzeng CW, Katz MH, Lee JE et al (2014) Predicting the risks of venous thromboembolism versus post-pancreatectomy haemorrhage: analysis of 13,771 NSQIP patients. HPB 16(4):373–383
pubmed: 23869628
Ramanathan R, Mason T, Wolfe LG et al (2018) Predictors of short-term readmission after pancreaticoduodenectomy. J Gastrointest Surg 22(6):998–1006
pubmed: 29404986
Simons JP, Shah SA, Ng SC et al (2009) National complication rates after pancreatectomy: beyond mere mortality. J Gastrointest Surg 13(10):1798–1805
pubmed: 19506975
Mukherjee D, Lidor AO, Chu KM et al (2008) Postoperative venous thromboembolism rates vary significantly after different types of major abdominal operations. J Gastrointest Surg 12(11):2015–2022
pubmed: 18668299
Haigh PI, Bilimoria KY, DiFronzo LA (2011) Early postoperative outcomes after pancreaticoduodenectomy in the elderly. Arch Surg (Chicago, Ill: 1960) 146(6):715–723
Kruger S, Haas M, Burkl C et al (2017) Incidence, outcome and risk stratification tools for venous thromboembolism in advanced pancreatic cancer - a retrospective cohort study. Thromb Res 157:9–15
pubmed: 28675831
Pelzer U, Opitz B, Deutschinoff G et al (2002) Efficacy of prophylactic low-molecular weight heparin for ambulatory patients with advanced pancreatic cancer: outcomes from the CONKO-004 trial. J Clin Oncol 33(18):2028–2034
Shaib W, Deng Y, Zilterman D et al (2010) Assessing risk and mortality of venous thromboembolism in pancreatic cancer patients. Anticancer Res 30(10):4261–4264
pubmed: 21036750
Ishigaki K, Nakai Y, Isayama H et al (2017) Thromboembolisms in advanced pancreatic cancer: a retrospective analysis of 475 patients. Pancreas. 46(8):1069–1075
pubmed: 28787333
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213
pubmed: 1360123
pmcid: 1360123
Wente MN, Bassi C, Dervenis C et al (2007) Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 142(5):761–768
pubmed: 17981197
Bassi C, Marchegiani G, Dervenis C et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery. 161(3):584–591
Wente MN, Veit JA, Bassi C et al (2007) Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 142(1):20–25
pubmed: 17629996
Wolk S, Linke S, Bogner A et al (2019) Use of activity tracking in major visceral surgery-the enhanced perioperative mobilization trial: a randomized controlled trial. J Gastrointest Surg 23(6):1218–1226
pubmed: 30298422
Wolk S, Distler M, Müssle B et al (2016) Adherence to ERAS elements in major visceral surgery-an observational pilot study. Langenbeck’s Arch Surg 401(3):349–356
Qanadli SD, El Hajjam M, Vieillard-Baron A et al (2001) New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. AJR Am J Roentgenol 176(6):1415–1420
pubmed: 11373204
Prandoni P, Falanga A, Piccioli A (2005) Cancer and venous thromboembolism. Lancet Oncol 6(6):401–410
pubmed: 15925818
Caprini JA (2009) Intermittent pneumatic compression and pharmacologic thrombosis prophylaxis. Curr Opin Pulm Med 15(5):439–442
pubmed: 19478668
Parry K, Sadeghi AH, van der Horst S et al (2017) Intermittent pneumatic compression in combination with low-molecular weight heparin in the prevention of venous thromboembolic events in esophageal cancer surgery. J Surg Oncol 115(2):181–185
pubmed: 28054341
Borly L, Wille-Jørgensen P, Rasmussen MS (2005) Systematic review of thromboprophylaxis in colorectal surgery -- an update. Color Dis 7(2):122–127
Kokudo T, Uldry E, Demartines N et al (2014) Pulmonary embolism: specific risk factor after pancreas resection? Pancreas. 43(6):891–894
pubmed: 24763075
Boone BA, Zenati MS, Rieser C et al (2019) Risk of venous thromboembolism for patients with pancreatic ductal adenocarcinoma undergoing preoperative chemotherapy followed by surgical resection. Ann Surg Oncol 26(5):1503–1511
pubmed: 30652227
Hwang IK, Kang BK, Lee YS et al (2015) Postoperative early thromboembolism as a prognostic indicator in patients with curatively resected pancreatic cancer. Am J Surg 210(5):871–877
pubmed: 26002191
Oh SY, Kim JH, Lee KW et al (2008) Venous thromboembolism in patients with pancreatic adenocarcinoma: lower incidence in Asian ethnicity. Thromb Res 122(4):485–490
pubmed: 18234292
White RH, Zhou H, Romano PS (1998) Incidence of idiopathic deep venous thrombosis and secondary thromboembolism among ethnic groups in California. Ann Intern Med 128(9):737–740
pubmed: 9556467
Stein PD, Kayali F, Olson RE et al (2004) Pulmonary thromboembolism in Asians/Pacific Islanders in the United States: analysis of data from the National Hospital Discharge Survey and the United States Bureau of the Census. Am J Med 116(7):435–442
pubmed: 15047032
Horsted F, West J, Grainge MJ (2012) Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis. PLoS Med 9(7):e1001275
pubmed: 22859911
pmcid: 3409130
Yhim HY, Jang MJ, Kwak JY et al (2013) The incidence, risk factors, and prognosis of recurrent venous thromboembolism (VTE) in patients with advanced solid cancers receiving anticoagulation therapy after the diagnosis of index VTE. Thromb Res 131(4):e133–e140
pubmed: 23399441
Williams TK, Rosato EL, Kennedy EP et al (2009) Impact of obesity on perioperative morbidity and mortality after pancreaticoduodenectomy. J Am Coll Surg 208(2):210–217
pubmed: 19228532
Ramsey AM, Martin RC (2011) Body mass index and outcomes from pancreatic resection: a review and meta-analysis. J Gastrointest Surg 15(9):1633–1642
pubmed: 21484490
Gilsdorf RB, Spanos P (1973) Factors influencing morbidity and mortality in pancreaticoduodenectomy. Ann Surg 177(3):332–337
pubmed: 4540286
pmcid: 1355536
Bakkevold KE, Kambestad B (1993) Morbidity and mortality after radical and palliative pancreatic cancer surgery. Risk factors influencing the short-term results. Ann Surg 217(4):356–368
pubmed: 7682052
pmcid: 1242802