జర్నల్ ఆఫ్ సర్జరీ

Impact of Chronic Pancreatitis on Pancreatic Resections for Malignancy

Abstract

Jill K Onesti1,2*, G Paul Wright1,2, Payal P Attawala2, Deepali H Jain1,2, Arida Siripong1 and Mathew H Chung1,2,3

Background: Chronic pancreatitis has been shown to have potential benefit in pancreatic resections by reducing postoperative pancreatic fistula. We sought to investigate the impact of chronic pancreatitis on oncologic surgical outcomes. Materials and Methods: Consecutive partial pancreatectomies performed for malignant disease from 2005-2011 were reviewed. Patients were divided for analysis based on the presence of chronic pancreatitis. The primary outcome measures were need for intraoperative re-excision of margins and final margin status. Secondary outcome measures included pancreatic fistula rate and overall morbidity which were graded in standardized fashion. Significance was assessed for p<0.05. Results: One hundred fifty-four patients met criteria for study, 48 of which had chronic pancreatitis. Demographics, co-morbidities, diagnoses, and surgical technique were equivalent between groups. Though there was a trend towards increased re-excision of margins in the chronic pancreatitis group (p<0.08), there were no significant differences in any surgical outcome measures between groups including final margin status, pancreatic fistula rate, and overall morbidity. Multivariate analysis failed to identify chronic pancreatitis as a predictive factor for any of the chosen outcome variables. Conclusion: Despite potential for difficult dissection due to inflammatory changes in chronic pancreatitis, we found no differences in oncologic outcomes in patients undergoing pancreatectomy.