Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).

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Massobrio, Andrea; Scabini, Stefano; Carganico, Giacomo; Pessia, Beatrice; Sista, Federico; Schietroma, Mario; G Spampinato, Marcello; Garritano, Stefano; D'Ugo, Stefano; Marchese, Tiziana; Saladino, Edoardo; Cuticone, Giuseppe; Gullá, Nino; Recordare, Alfonso; Palumbo, Rubina; Giani, Alessandro; Ferrari, Giovanni; Mazzola, Michele; Dondossola, Daniele; Rossi, Giorgio; Caccamo, Lucio; Zerbi, Alessandro; Nappo, Gennaro; Montorsi, Marco; Coppa, Jorgelina; Droz Dit Busset, Michele; Mazzaferro, Vincenzo; Troci, Albert; Frontali, Alice; Crespi, Michele; Baldi, Caterina; Benuzzi, Laura; Ferrara, Francesco; Stella, Marco; Capurso, Gabriele; Falconi, Massimo; Tamburrino, Domenico; Di Benedetto, Fabrizio; Magistri, Paolo; Ballarin, Roberto; Zanus, Giacomo; Brizzolari, Marco; Uggeri, Fabio; Gianotti, Luca; Cereda, Marco; Ferraro, Daniele; Iacomino, Alessandro; Ferraro, Daniele; Pisaniello, Donatella; Vennarecci, Giovanni; Pisaniello, Donatella; Rompianesi, Gianluca; Ivan Troisi, Roberto; Patrone, Renato; Belli, Andrea; Izzo, Francesco; Palaia, Raffaele; Gianpaolo, Marte; Maida, Pietro; Pasquale, Tammaro; Bassi, Domenico; Cillo, Umberto; Moletta, Lucia; Sperti, Cosimo; Serafini, Simone; Caterina Milanetto, Anna; Pasquali, Claudio; Tolin, Francesca; Gruppo, Mario; De Simoni, Ottavia; Buscemi, Salvatore; V Marino, Marco; Giuffrida, Mario; Dallavalle, Raffaele; Calabretto, Francesca; Cobianchi, Lorenzo; Pugliese, Luigi; Giardino, Alessandro; Butturini, Giovanni; Regi, Paolo; Federico Kauffmann, Emanuele; Di Franco, Gregorio; Morelli, Luca; Furbetta, Niccolò; Napoli, Niccoló; Boggi, Ugo; Pinotti, Enrico; Montuori, Mauro; Giuliani, Antonio; Lucia Izzo, Maria; Zanini, Nicola; Veneroni, Luigi; Giordano, Marco; Marco Palini, Gian; Garulli, Gianluca; La Vaccara, Vincenzo; Maria de Rose, Agostino; Giuliante, Felice; Ardito, Francesco; Mingoli, Andrea; Sapienza, Paolo; Lapolla, Pierfrancesco; Petrucciani, Niccolo; Cossa, Alessandra; Coppola, Alessandro; Belloni, Elena; Nigri, Giuseppe; Tisone, Giuseppe; Angelico, Roberta; Maria Manzia, Tommaso; Caputo, Damiano; Di Saverio, Salomone; Porcu, Alberto; Perra, Teresa; Feo, Claudio; Deiana, Giulia; Sartarelli, Lodovico; Pisconti, Salvatore; Tonini, Valeria; Patrono, Damiano; Moro, Francesco; Grasso, Luca; Brolese, Alberto; Ciarleglio, Francesco; Marcucci, Stefano; Nistri, Cristina; Massani, Marco; Tommaso, Stecca; Galasso, Elisa; Zanus, Giacomo; Brizzolari, Marco; Romano, Maurizio; Rossi, Serena; Novello, Simone; Ferrero, Alessandro; Langella, Serena; Armentano, Serena; Russolillo, Nadia; Dario, Lorenzin; Intini, Sergio; Giovanni, Terrosu; Giovanni Recordare, Alfonso; Pirozzolo, Giovanni; Palumbo, Rubina; Calabrese, Francesco; Querini, Giorgio; Zonta, Sandro; Caneparo, Andrea; Giacometti, Marco; De Francesco, Maura; Balduzzi, Alberto; Guglielmi, Alfredo; Ruzzenente, Andrea; Iacono, Calogero; Poletto, Edoardo; Marchegiani, Giovanni; Isa, Giulia; Malleo, Giuseppe; Alaimo, Laura; Salvia, Roberto; Conci, Simone; Francesco Crinò, Stefano; Campagnaro, Tommaso; Frigerio, Isabella; De Marchi, Francesco; Bonomo, Michele; Napetti, Sara; Frontali, Alice; Chierici, Andrea; Cotsoglou, Christian; Gjoni, Elson; Paleino, Sissi; Granieri, Stefano; Hashimoto, Daisuke; Satoi, Sohei; Yamamoto, Tomohisa; Uemura, Kenichiro; Matsumoto, Ippei; Kamei, Keiko; Maehira, Hiromitsu; Tani, Masaji; Hirano, Satoshi; Nakamura, Toru; Asano, Toshimichi; Akahoshi, Keiichi; Tanabe, Minoru; Ishii, Takeshi; H Al Saffaf, Mohamed; Al Hamoud, Mohammad; Khattab, Rahaf; Alissawi, Subhi; Hassouneh, Anas; Al-Maadani, Basma; Bilal Alali, Mahmoud; Ahmad Hmdan, Quasi; Obed, Aiman; Nijadat, Dania; Al-Shami, Khayry; Al-Shami, Manar; Mohsen, Maram; Al-Mallah, Rozana; Albaba, Safa'; Theab, Mohammad; Massadeh, Noor; Abdelrahman Khader Theab, Reem; Wardeh, Salah; Zahi Alissawi, Subhi; Mardini, Anas; Ayman Abdelhalem Arabiyat, Hamza; Arabiyat, Hamza; Al-Hyari, Abdelkareem; Ababneh, Hazim; Fawzat Naffa', Mo'Taz; Musallam Buwaitel, Mohammad; Al-Mekhlafi, Ayat; Rababa, Hebah; Alzoubi, Mohammed; Khamees, Almuatasim; Abuleil, Amro; Almiani, Sari; Obeidat, Khaled; Amarin, Zouhair; Al-Samawi, Abdulaziz; A Al Hammoud, Amr; Hammad, H; Ali Alkhadem, Maeen; R Mahafdah, Mahmoud; Alsaffaf, Mohamed; Alsabah, Mohamed; Bani Hani, Mohammad; A Al Hamoud, Mohammad; W Alzghoul, Mohammad; N Khattab, Rahaf; K Shumrakh, Saeed; Rababah, Ansam; Alghazo, Heyam; Rababah, Tasneem; Khamees, Almu'Atasim; Awadi, Sajeda; Al Sharie, Sarah; Abdelnoor, Ahmad; Mohammad Shaout, Duaa; Omarieh, Qais; Yassir Abu-Ghazal, Sara; Abu-Ghazal, Sara; Shaout, Dua'A; Yasser Abughazal, Sara; Fakhradiyev, Ildar; Tanabayeva, Shynar; Saliev, Timur; Issabekov, Ibragim; Spatayev, Zhanat; Han, Ho-Seong; Jo, Yeongsoo; Plaudis, Haralds; Deja Martinsone, Katrina; Atstupens, Kristaps; Jawad, Mohamad; Khalife, Mohamad; Ghazi Faraj, Walid; Alowjali, Fatoom; N Albaraesi, Mohammed; Aldressi, Wafa; Benamwor, Aihab; Ben Ali, Suhil; Saleh, Suhil; Alshatshat, Abdulhadi; Younes, Eman; Younes, Eman; Ekhmaj, Reyad; Bahroun, Sumayyah; Ghayth Bahroun, Sumayyah; Ekhmaj, Reyad; Ghayth Bahroun, Sumayyah; Burgan, Dania; Abd Alhamed Aalem, Hajer; Kamoka El Hussain, Ramadan; Morgom, Marwa; Alshareea, Entisar; Ali Dakheel Ellafi, Amera; Shoukrie, Shoukrie; Mahmoud Omar Shamakhi, Taha; Bareig, Elham; Abusannuga, Malek; Dkhakhni, Abdulbari; Abdualla Gerwash, Ahmed; Gerwash, Ahmed; Zawia, Ali; Othman, Eman; Binnawara, Muhannud; Juma Ali Abdalsalam, Sabriya; Aljamal, Sarah; Ahmeed, Sultan; Ibrahim Almabrouk Khalil, Wegdan; Khalel, Wegdan; Faraj, Tasneem; Elhajdawe, Fras; Emhemed, Marwa; Salem, Osama; Abdulwahed, Eman; Khalil, Wegdan; Rhuma, Heba; Alsori, Mohamed; Mustafa, Tahani; Albarouni, Sofian; Albishti, Ahmed; Elhadi, Muhammed; Elkhuja, Taha; Msherghi, Ahmed; Shaban Ben Hasan, Najat; Ben Hasan, Hayat; Ben Hasan, Najat; Gulbinas, Antanas; Barauskas, Giedrius; Ignatavicius, Povilas; Riauka, Romualdas; Vanagas, Tomas; Slepavicius, Algirdas; Jurgaitis, Jonas; Dailidenas, Sarunas; Eismontas, Vitalijus; Mikutaitis, Vytenis; Šlepavičius, Algirdas; Jurgaitis, Jonas; Mikutaitis, Vytenis; Dulskas, Audrius; Kuliavas, Justas; Aniukstyte, Laura; Sileikis, Audrius; Gulla, Aiste; Šileikis, Audrius; Tumas, Jaroslav; Strupas, Kestutis; Petrulionis, Marius; Kvietkauskas, Mindaugas; Strupas, Kestutis; Vito, Deblasi; Rosso, Edoardo; Huei Tan, Jih; Dzulkarnaen Zakaria, Andee; Sani Mohamad, Ikhwan; Voon Meng, Leow; Zhan Huai, Teoh; Hayati, Firdaus; Sellappan, Harivinthan; Kumar Maiyauen, Thanesh; Azman, Azlanudin; Chik, Ian; Zuhdi, Zamri; Yoong, Boon; Peng Soon, Koh; Jun Kit, Koong; Koon Yoong, Boon; Kit Koong, Jun; Soon Koh, Peng; Ibrahim, Aini; Azim Nik Abdullah, Nik; Bong, Jin; Ghani, Shahi; Florez Zorrilla, Carlos; Charco Cruz, Miguel; Moguel Valladares, Andre; Dominguez-Rosado, Ismael; Eduardo Padilla Rosciano, Alejandro; Sebastian, Garcia-Herrera; Melchor-Ruan, Javier; Sebastian Garcia-Herrera, Juan; Sandag, Erdene; Erdene, Sarnai; Orgoi, Sergelen; Korch, Moniba; Sami Boutti, Ahmed; Boumzebra, Yassmine; Boumzebra, Yassmine; Hourri, Fatine; Gouazar, Iltimass; Ait Belaid, Wafae; Serji, Badr; Tarik, Bouhout; Harroudi Tijani, El; Zentar, Aziz; Ghannam, Abdelilah; Bounaim, Ahmed; Souadka, Amine; Benkabbou, Amine; El Ahmadi, Brahim; Amina, Houmada; Oumayma, Lahnaoui; Amrani, Laila; Anass Majbar, Mohammed; Mohsine, Raouf; Elhassouni, Reda; Echiguer, Sabrillah; Belkhadir, Zakaria; Pueya Nashidengo, Abdulrashid; Quayson, Francis; Abebrese, John; Nashidengo, Pueya; Mohan Adhikari, Krishna; Joshi Lakhey, Paleswan; Singh Bhandari, Ramesh; G Besselink, Marc; Bieze, Matthanja; Augustinus, Simone; Busch, Olivier; K Pranger, B; H Hoogwater, F J; M Klaase, J; Meerdink, M; W Nijkamp, M; E de Meijer, V; Groot Koerkamp, Bas; Hj van Eijck, Casper; L Van Dam, Jacob; Barbier, Louise; Johnston, Peter; Babor, Richard; Jen Jie Chu, Michael; Oliver, Tiffany; Wen, Daniel; Koea, Jonathan; Koea, Jonathan; Brown, Lisa; Srinivasa, Sanket; Bartlett, Adam; Windsor, John; Carr-Boyd, Peter; Bindra, Vanshay; Cross, Andrea; Connor, Saxon; Hore, Todd; Gunawardene, Ashok; Welsh, Fraser; Mahadik, Monique; Gordon, Alexandra; Rossaak, Jeremy; Adeyeye, Ademola; Enoch, Elizabeth; Kayode-Nissi, Victor; Abiyere, Henry; Alatise, Olusegun; Okomayin, Andrew; Odion, Clement; Tagar, Esteem; Abba Sheshe, Abdulrahaman; Bala Muhammad, Abubakar; Umar Garzali, Ibrahim; Ajayi, Peter; Kadri, Exhevit; Al Jabri, Salah; Al Azri, Yahya; Muahammad Inam Pal, Khuwaja; Siddiqui, Tayyab; Waqar, Usama; Waqar, Usama; Areeb Chaudhry, Ahmad; Abbasy, Jibran; Osama Khan, Muhammad; Shafqatullah, Syed; Imran Khokhar, Muhammad; Akbar, Ali; Afzal, Ameer; Asghar, Mohammad; Ullah, Sami; Ismat Butt, Usman; Butt, Usman; Bari, Hassaan; Nabil Mohammad, Bilal; Hameda, Mahmoud; Abu Jayyab, Mustafa; Hasan Mohammad Alzabadiah, Asmaa; Adam, Islam; Abuzaina, Khalil; Farid, Mohammad; Farid Mohammad Emar, Mohammad; Emar, Mohammad; Zreqat, Qusai; Titi, Rawand; Ameen Idkiedek, Sarah; Amro, Sarah; Al-Qasrawi, Shahd; Abedlnaser Almasri, Tabarak; Mohammed Alnammourah, Walaa; Kiswani, Gharam; Sinnokrot, Raghida; Abu Harb, Zahrah; Nafa'A, Hiba; Shtewi, Lyana; Omar Salah, Abrar; A Joma, Aseef B; Faraj, Sireen; Zitawi, Abdullah; Jamal Dawood, Ahmad; Saadeh, Ibraheem; Hmeedan, Alaa; Ayman Mahmoud Daraghmeh, Motaz; Netham Atia Janajreh, Amani; Manassra, Fatima; Moayyad Ahmed Yassin, Laya; Yassin, Raya; Omar Saleh, Abrar; Mahmoud Faraj, Sireen; S Sulaiman, Abdallah; Khayyat, Zain; A Joma, Aseef B; Shawahni, Eman; Salah, Abrar; Khader, Abdullatef; Hammoudeh, Ahlam; Abdulhaq, Aram; Alawna, Reem; Roman, Gilbert; Targarona, Javier; Garatea Grau, Rafael; Molina, Raquel; Rodriguez Alegria, Cesar; Coayla, Guillermo; Carlos Marcos Enriquez, Juan; Carlos Marcos, Juan; Nicole Hasiman, Alyssa; Teh, Catherine; Cerdeño, Ruby; David, Avril; I Sarmiento, Ray; Ruel Barroso, Ryan; Alfonso, Cenon; Dante Ang, Dr; Casupang, Amornetta; Mamuric, Monica; Mari Jardinero, Jose; Motyka, Agata; Flisińska, Marta; Pierściński, Stanisław; Mrowiec, Slawomir; Rymarowicz, Justyna; Matyja, Maciej; Wikar, Tomasz; Sierzega, Marek; Pędziwiatr, Michał; Richter, Piotr; 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Arbutina, Dragana; Milic, Ljiljana; Bezmarevic, Mihailo; Antic, Andrija; Radenkovic, Dejan; Ignjatovic, Igor; Zdujic, Predrag; Kmezic, Stefan; Karamarkovic, Aleksandar; Arbutina, Dragana; Juloski, Jovan; Radulovic, Radisav; Radulović, Radosav; Cuk, Vladica; Jeremic, Ljiljana; Radojkovic, Milan; Stojanovic, Miroslav; Golijanin, Danica; Kresoja Ignjatovic, Milana; Protic, Mladjan; Chiow, Adrian; Lip Seng, Lee; Thiruchelvam, Nita; Goh Kim Poh, Brian; P Goh, Brian K; Chua Wei Quan, Darren; Xin Koh, Ye; Trotovšek, Blaž; Petrič, Miha; Djokić, Mihajlo; Tomazic, Ales; Badovinac, David; Loots, Emil; Prodehl, Leanne; Uzayr Khan, Mohammed; Marumo, Thomas; Ws Devar, John; Omoshoro-Jones, Jones; A Khan, Zafar; Jugmohan, Ben; Quiroga Valcarcel, Ana; Matías García, Belén; Mínguez, Javier; Marcello, Manuel; Ramia, Jose; Compañ, Antonio; Fernandes, Carlos; Morales, Miguel; Miguel Vargas Fernández, Jose; Del Mar Rico-Morales, Maria; Ángel Lorenzo Liñán, Miguel; Figueras, Joan; Soliva, Ramon; Butori, Eugenia; 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Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Irene Urciuoli;
2024

Abstract

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
2024
pancreatic surgery; morbidity; failure to rescue; human development index
01 Pubblicazione su rivista::01a Articolo in rivista
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Ali Abdullah Yahya Ali, Ramzi; Albar, Aisha; Abdullh Bleem, Hikma; Sultan Ali Galeb, Khaled; Ghushaim, Mohammed; Sabbar, Mohammed; Esmail, Muhib; Abdullah Yahya Ali, Ramzi; Hassan Mohammed Salem, Rana; Salem, Rana; Saif, Wail; Al-Faiq, Siham; Alsharabi, Ebrahim; Tofik Abdul Hameed, Almekhlafi; Almekhlafi, Tofik; Omairan, Abdulrahman; Almarkiz, Eman; Abduljawad, Heba; Mansaleh, Omair; Al-Melhani, Watheeq; Abdualqader, Mahmmoud; Al-Abdi, Radfan; Mohammed Alwan, Hussein; Mbanje, Chenesa; Chihaka, Onesai. - In: BRITISH JOURNAL OF SURGERY. - ISSN 0007-1323. - (2024).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1718769
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