Postpancreatectomy acute pancreatitis in pancreaticoduodenectomy and distal pancreatectomy: a retrospective cohort study on risk factors and clinical outcomes.

BACKGROUND

Postpancreatectomy acute pancreatitis (PPAP) is a severe complication that can occur following pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). Specific studies focus on the difference of PPAP in PD and DP are lacking.

METHODS

Patients who underwent PD or DP between 2019 and 2024 were retrospectively reviewed. Perioperative parameters and outcomes were collected. PPAP was defined in accordance with the criteria established by the International Study Group for Pancreatic Surgery (ISGPS).

RESULTS

The study cohort comprised 1,017 patients undergoing pancreatic resection: 670 PD and 347 DP. Among PD cases, PPAP occurred in 142 patients (21.19%) and was significantly associated with a higher incidence of postoperative pancreatic fistula (POPF) (82.39% vs. 37.12%, P < 0.0001), particularly in cases of grade B and C POPF (P < 0.0001). In DP cases, PPAP occurred in 17.58% of patients. In PD cases, patients with PPAP experienced increased morbidity (P < 0.0001), including a higher incidence of POPF (91.8% vs. 65.38%, P < 0.0001) and grade B POPF (39.34% vs. 11.54%, P < 0.0001). Compared to patients who had PD, those who had DP experienced a lower incidence of postoperative hyperamylasemia (POH) (30.55% vs. 43.88%, P < 0.0001).

CONCLUSION

PPAP represents a significant postoperative complication following pancreatic resection. Current evidence suggests associations between PPAP and morbidities in PD and DP cases. Notably, PPAP following DP appears to correlate with less severe clinical consequences compared to PD-associated PPAP.