{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:39:31Z","timestamp":1788503971977,"version":"build-2803163510"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"Dutch Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deltaplan Alvleesklierkanker","award":["NCT05524090"],"award-info":[{"award-number":["NCT05524090"]}]},{"name":"Cultuurfonds"},{"DOI":"10.13039\/501100017636","name":"Cancer Center Amsterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001725","name":"Royal Swedish Academy of Sciences","doi-asserted-by":"publisher","award":["LM2021-0010"],"award-info":[{"award-number":["LM2021-0010"]}],"id":[{"id":"10.13039\/501100001725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001725","name":"Royal Swedish Academy of Sciences","doi-asserted-by":"publisher","award":["LM2023-0012"],"award-info":[{"award-number":["LM2023-0012"]}],"id":[{"id":"10.13039\/501100001725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["SLS-934237"],"award-info":[{"award-number":["SLS-934237"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Region V\u00e4sterbotten in Ume\u00e5, Sweden","award":["RV 967602"],"award-info":[{"award-number":["RV 967602"]}]},{"DOI":"10.13039\/100016669","name":"Sj\u00f6berg Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016669","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bengt Ihre Research Foundation","award":["SLS-986656"],"award-info":[{"award-number":["SLS-986656"]}]},{"DOI":"10.13039\/501100014031","name":"Cancerforskningfonden i Norrland","doi-asserted-by":"publisher","award":["AMP 23-1127"],"award-info":[{"award-number":["AMP 23-1127"]}],"id":[{"id":"10.13039\/501100014031","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bengt Ihre Research Fellowship Grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The increased use of superior mesenteric artery (SMA) divestment has been a driver behind the increased resection rate for locally advanced pancreatic cancer following preoperative therapy. This has also resulted in an increase in the rate of postoperative neurogenic diarrhoea, but knowledge about postoperative neurogenic diarrhoea is lacking. The aims of this study were to determine the incidence, risk factors, management, and outcomes of neurogenic diarrhoea after SMA divestment\/resection for pancreatic adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective study included consecutive patients undergoing pancreatic adenocarcinoma resection, including SMA divestment\/resection, after preoperative chemotherapy with or without radiotherapy between 2016 and 2022. Primary endpoints were the incidence of postoperative neurogenic diarrhoea, associated factors, treatment strategies, and outcomes. Secondary endpoints were the rate of adjuvant chemotherapy and the impact of neurogenic diarrhoea on overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 291 patients who underwent pancreatic resection with concomitant SMA divestment (240, 82%) or resection (51, 18%) were included in the study. Postoperative neurogenic diarrhoea was diagnosed in 193 patients. The adjusted risk of developing neurogenic diarrhoea was 59% (95% confidence interval (c.i.) 46 to 73) after \u2264 180\u00b0 SMA divestment, 80% (95% c.i. 67 to 93) after &amp;gt; 180\u00b0 SMA divestment, and 77% (95% c.i. 66 to 88) after SMA resection. Postoperative neurogenic diarrhoea was treated with non-opioid drugs (29, 15%), non-opium opioids (140, 73%), opium tincture (69, 36%), and\/or octreotide (49, 25%), and normalized in 51% of patients. After adjusting for confounders, neurogenic diarrhoea was not significantly associated with OS (hazard ratio 0.83; 95% c.i. 0.55 to 1.25).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neurogenic diarrhoea occurred in two-thirds of patients following resection of pancreatic adenocarcinoma with concomitant SMA divestment\/resection, particularly after &amp;gt; 180\u00b0 SMA divestment or SMA resection. Although challenging to manage, neurogenic diarrhoea is not associated with impaired OS. Evidence-based treatment strategies are needed for adequate management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag057","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:42:40Z","timestamp":1776339760000},"source":"Crossref","is-referenced-by-count":1,"title":["Neurogenic diarrhoea after superior mesenteric artery divestment or resection for pancreatic adenocarcinoma following preoperative chemotherapy: international multicentre retrospective study"],"prefix":"10.1093","volume":"10","author":[{"given":"Thomas F","family":"Stoop","sequence":"first","affiliation":[{"name":"Amsterdam UMC, Location University of Amsterdam, Department of Surgery , Amsterdam ,","place":["the Netherlands"]},{"name":"Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus , Aurora, Colorado ,","place":["USA"]},{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Croce","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus , Aurora, Colorado ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus , Aurora, Colorado ,","place":["USA"]},{"name":"Department of Hepatobiliary and Pancreatic Surgery, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-6323","authenticated-orcid":false,"given":"Mahsoem","family":"Ali","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]},{"name":"Amsterdam UMC, Location Vrije University, Department of Surgery , Amsterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar A","family":"Javed","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, NewYork University Medical Center , New York City, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Halimi","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Surgery, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7315-0830","authenticated-orcid":false,"given":"Atsushi","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Institute of Science Tokyo , Tokyo ,","place":["Japan"]},{"name":"Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6973","authenticated-orcid":false,"given":"Bas","family":"Groot Koerkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute, University Medical Center , Rotterdam ,","place":["the 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