Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2018; 10(8): 84-89
Published online Nov 27, 2018. doi: 10.4240/wjgs.v10.i8.84
Male gender and increased body mass index independently predicts clinically relevant morbidity after spleen-preserving distal pancreatectomy
Traian Dumitrascu, Mihai Eftimie, Andra Aiordachioae, Cezar Stroescu, Simona Dima, Mihnea Ionescu, Irinel Popescu
Traian Dumitrascu, Mihai Eftimie, Andra Aiordachioae, Cezar Stroescu, Simona Dima, Mihnea Ionescu, Irinel Popescu, Department of General Surgery and Liver Transplant, Fundeni Clinical Institute, Bucharest 022328, Romania
Author contributions: All authors helped to perform the research and to write the manuscript; Dumitrascu T, Aiordachioae A, Eftimie M and Dima S contributed to drafting conception and design; Dumitrascu T and Aiordachioae A contributed to data analysis; Dumitrascu T, Stroescu C, Ionescu M and Popescu I contributed to performing procedures.
Institutional review board statement: This study was retrospective, and no interference with patients’ treatment was made. Thus, the approval by the Ethics Committee of the Fundeni Clinical Institute was waived.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous retrospective clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Traian Dumitrascu, MD, PhD, Senior Lecturer, Department of General Surgery and Liver Transplant, Fundeni Clinical Institute, Fundeni Street no 258, Bucharest 022328, Romania. traian.dumitrascu@umfcd.ro
Telephone: +40-21-3180417 Fax: +40-21-3180417
Received: August 1, 2018
Peer-review started: August 1, 2018
First decision: August 24, 2018
Revised: September 24, 2018
Accepted: November 4, 2018
Article in press: November 4, 2018
Published online: November 27, 2018
Abstract
AIM

To identify risk factors for clinically relevant complications after spleen-preserving distal pancreatectomy (SPDP). No previous studies explored potential predictors of morbidity after SPDP.

METHODS

The data of 41 patients who underwent a SPDP in a single surgical center between 2000 and 2015 were retrospectively reviewed from a prospectively maintained electronic database established in our Department of Surgery. The database included demographic, clinical, bioumoral, pathological, intraoperative and postoperative parameters. Uni- and multivariate analyses were performed to assess potential predictors of clinically relevant morbidity. Postoperative morbidity was defined as in-hospital complications and mortality was assessed at 90 d. Clinically relevant morbidity was defined as complication ≥ grade 2 Dindo.

RESULTS

Overall morbidity rate was 34.1% (14 patients): grade I (6 patients, 14.6%), grade II (2 patients, 4.8%), grade IIIa (1 patient, 2.4%), and grade IIIb (5 patients, 12.2%). A number of 5 patients (12.2%) required re-laparotomy for postoperative complications. There was no postoperative mortality. Thus, at least one clinically relevant complication occurred in 8 patients (19.5%). Univariate analysis identified male gender (P = 0.034), increased body mass index (P = 0.002) and neuroendocrine pathology (P = 0.013) as statistically significant risk factors. Multivariate analysis identified male gender [odds ratio (OR): 1.29, 95%CI: 1.07-1.55, P = 0.005] and increased body mass index (OR: 23.18, 95%CI: 1.72-310.96, P = 0.018) as the only independent risk factors of clinically relevant morbidity after SPDP.

CONCLUSION

Male gender and increased body mass index are independently associated with increased risk of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.

Keywords: Spleen-preserving distal pancreatectomy, Morbidity, Male gender, Body mass index

Core tip: No previous studies explored potential predictors of morbidity after spleen-preserving distal pancreatectomy (SPDP). The study aims to identify risk factors for clinically relevant complications after SPDP. Data of 41 patients with SPDP were reviewed and uni- and multivariate analyses were performed to assess potential predictors of clinically relevant morbidity, defined as complication ≥ grade 2 Dindo. The rate of clinically relevant complications was 19.5%. Male gender [odds ratio (OR): 1.29, 95%CI: 1.07-1.55, P = 0.005] and increased body mass index (OR: 23.18, 95%CI: 1.72-310.96, P = 0.018) were found as independent risk factors of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.