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Predictors of post-operative pancreatic fistula formation in pancreatic neuroendocrine tumors: A national surgical quality improvement program analysis

      Highlights

      • Post-operative pancreatic fistula is higher in pancreatic neuroendocrine tumors.
      • Male sex, pancreaticoduodenectomy, small duct, and soft gland have higher leak rate.
      • Tumor stage, nodes, metastasis, race, and age were not associated with leak rate.
      • Functioning and non-functioning tumors had similar post-operative leak rates.
      • Post-operative pancreatic fistula rates did not change between 2014 and 2018.

      Abstract

      Background

      Post-operative pancreatic fistula (POPF) is a serious complication following pancreas surgery. We aimed to establish factors associated with POPF specifically in patients with pancreatic neuroendocrine tumors (PNET).

      Methods

      The 2014–2018 American College of Surgeons National Surgical Quality Improvement Program database was querried for patients undergoing resection for PNET. The impact of patient, tumor, and operative factors on POPF formation was evaluated.

      Results

      3532 patient underwent resections for PNET. The POPF rate was significantly higher in patients with PNET (24.8%) versus non-PNET (16.4%) (p < 0.0001). Male sex (OR 1.45, 95% CI 1.11–1.89), enucleation (OR 3.14, 95% CI 1.10–8.98), pancreaticoduodenectomy (OR 1.51, 95% CI 1.13–2.03), small duct size <3 mm (OR 3.24, 95% CI 1.62–6.48), and soft gland texture (OR 1.81, 95% CI 1.18–2.77) were independently associated with POPF in PNET patients on multivariable analysis.

      Conclusions

      POPF is more common in patients undergoing resection for PNET and is dictated primarily by surgical approach and gland characteristics.

      Keywords

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