UKINETS2024 22nd Annual Meeting of the UK and Ireland Neuroendocrine Tumour Society 2024 Poster Presentations (33 abstracts)
Leak rates in pancreatico-duodenectomy procedures in pancreatic NETs compared to pancreatic ductal adenocarcinoma resections
Jahnavi Kalepu 1 , Senthil Sundaravadanan 2 , Thomas Pike 2 , Dimitrios Karavias 2 , Zaed Z.R. Hamady 2 , Ali Arshad 2 , John Primrose 2 , Thomas Armstrong 2 & Arjun Takhar 2
1Faculty of Medicine, University of Southampton, Southampton, United Kingdom. 2University Hospital Southampton NHS Trust, Southampton, United Kingdom
Introduction: Pancreatic resection for Neuroendocrine tumour is associated with a higher risk of anastomotic leak and post-operative pancreatic fistula (POPF).
Aim(s): The aim of this study was to compare POPF rate after Whipple’s operation for neuroendocrine tumour (NET) versus pancreatic ductal adenocarcinoma (PDAC).
Materials and Methods: We conducted a retrospective case control analysis of a prospectively maintained database. Patients who underwent pancreatico-duodenectomy for NET and PDAC over a 10 year period at our institution were included in the study. Drain amylase levels on day 3 and day 5 were compared in the two groups by Mann-Whitney U test with p<0.05 considered a significant result. The definition of pancreatic fistula as defined by the International Study Group of Pancreatic Fistula was used.
Results: A total of 660 patients underwent pancreatico-duodenectomy over a 10 year period. Of these, 44 (20.4%) underwent a resection for neuroendocrine tumour. 28 were males (63.6%) and 16 females (36.4%) with a median age of 62.5. 3 patients (6.8%) out of 44 had duodenal NETs. The drain amylase level (X3 normal) was elevated in 28 (63.6%) of the resections for NET as compared to 7 (15.9%) of the resections for PDAC at day 3 post procedure (p<0.05). On day 5 post operation, the drain amylase was elevated in 7 (15.9%) patients in the NET group as compared to 2 (4.5%) patients in the PDAC group (p<0.05).
Conclusion: As expected the drain amylase levels after pancreatic-duodenectomy were significantly higher in the NET group than in the PDAC group. The caliber of the pancreatic duct, normal pancreatic consistency (so called ’soft pancreas’) and loss of pancreatic exocrine function in a chronically (secondary to tumour) obstructed gland have been cited as reasons for this difference.
Keywords: pancreatic resections, whipple, pancreatic fistula, drain amylase
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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