{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:26:55Z","timestamp":1787081215123,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreaticoduodenectomy (PD) in dialysis patients is rare but carries a high risk of complications and mortality. This study aimed to identify preoperative factors associated with severe postoperative complications and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Japanese National Clinical Database, 329 dialysis patients undergoing PD between 2016 and 2020 were retrospectively analyzed. Multivariable penalized logistic regression identified preoperative risk factors for Clavien\u2013Dindo classification (CDC) grade \u2265\u20094 complications, 30\u2010day mortality, operative mortality, postoperative sepsis, and postoperative pancreatic fistula (POPF) (grade B or C).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CDC grade \u2265\u20094 complications, 30\u2010day mortality, and operative mortality occurred in 10.3%, 5.5%, and 11.2%, respectively. Diet\u2010 or oral medication\u2013treated diabetes (Odds ratio 5.19, 95% confidence interval 1.19\u201322.66) and insulin\u2010treated diabetes (7.50, 1.61\u201334.93) independently predicted 30\u2010day mortality. Serum albumin levels &lt;\u20093.0\u2009g\/dL independently predicted operative mortality (2.72, 1.05\u20137.02), while cardiovascular disease showed a borderline association (2.15, 0.95\u20134.85). Elevated CRP was significantly associated with postoperative sepsis (2.47, 1.07\u20135.67), and pancreatic cancer was associated with a lower risk of POPF (grade B or C) (0.59, 0.37\u20130.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dialysis patients undergoing PD face perioperative risks. Early mortality is driven by acute metabolic and infectious vulnerability, whereas operative mortality reflects diminished physiologic reserve related to malnutrition and cardiovascular comorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70102","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T04:21:34Z","timestamp":1776658894000},"page":"624-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Preoperative Factors of Dialysis Patients Who Underwent Pancreaticoduodenectomy on Postoperative Complications, 30\u2010Day and Operative Mortality: Analysis Using the Japanese National Clinical Database"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-1103","authenticated-orcid":false,"given":"Michinori","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic 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