• Anouk E J Latenstein, Lianne Scholten, Hasan Ahmad Al-Saffar, Bergthor Björnsson, Giovanni Butturini, Giovanni Capretti, Nikolaos A Chatzizacharias, Chris Dervenis, Isabella Frigerio, Tom K Gallagher, Silvia Gasteiger, Asif Halimi, Knut J Labori, Greta Montagnini, Luis Muñoz-Bellvis, Gennaro Nappo, Andrej Nikov, Elizabeth Pando, PastenaMatteo deMGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy., Peña-MoralJesús M de laJMDepartment of Pathology, Hospital Clínico Universitario ''Virgen de la Arrixaca,'' Murcia, Spain., Dejan Radenkovic, Keith J Roberts, Roberto Salvia, Francisco Sanchez-Bueno, Chiara Scandavini, Mario Serradilla-Martin, Stefan Stättner, Ales Tomazic, Martin Varga, Hana Zavrtanik, Alessandro Zerbi, Mert Erkan, Jörg Kleeff, Mickaël Lesurtel, Marc G Besselink, Jose M Ramia-Angel, and Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA).
• Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
• Ann. Surg. 2022 Nov 1; 276 (5): e536-e543.

ObjectiveTo assess outcomes among patients undergoing total pancreatectomy (TP) including predictors for complications and in-hospital mortality.BackgroundCurrent studies on TP mostly originate from high-volume centers and span long time periods and therefore may not reflect daily practice.MethodsThis prospective pan-European snapshot study included patients who underwent elective (primary or completion) TP in 43 centers in 16 European countries (June 2018-June 2019). Subgroup analysis included cutoff values for annual volume of pancreatoduodenectomies (<60 vs ≥60).Predictors for major complications and in-hospital mortality were assessed in multivariable logistic regression.ResultsIn total, 277 patients underwent TP, mostly for malignant disease (73%). Major postoperative complications occurred in 70 patients (25%). Median hospital stay was 12 days (IQR 9-18) and 40 patients were readmitted (15%). In-hospital mortality was 5% and 90-day mortality 8%. In the subgroup analysis, in-hospital mortality was lower in patients operated in centers with ≥60 pancreatoduodenectomies compared <60 (4% vs 10%, P = 0.046). In multivariable analysis, annual volume <60 pancreatoduodenectomies (OR 3.78, 95% CI 1.18-12.16, P = 0.026), age (OR 1.07, 95% CI 1.01-1.14, P = 0.046), and estimated blood loss ≥2L (OR 11.89, 95% CI 2.64-53.61, P = 0.001) were associated with in-hospital mortality. ASA ≥3 (OR 2.87, 95% CI 1.56-5.26, P = 0.001) and estimated blood loss ≥2L (OR 3.52, 95% CI 1.25-9.90, P = 0.017) were associated with major complications.ConclusionThis pan-European prospective snapshot study found a 5% inhospital mortality after TP. The identified predictors for mortality, including low-volume centers, age, and increased blood loss, may be used to improve outcomes.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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