{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:16:59Z","timestamp":1793272619778,"version":"4.5.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Pancreatic adenocarcinoma located in the pancreatic body might require a portomesenteric venous resection (PVR), but data regarding surgical risks after distal pancreatectomy (DP) with PVR are sparse. Insight into additional surgical risks of DP-PVR could support preoperative counseling and intraoperative decision making. This study aimed to provide insight into the surgical outcome of DP-PVR, including its potential risk elevation over standard DP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective, multicenter study including all patients with pancreatic adenocarcinoma who underwent DP\u2009\u00b1\u2009PVR (2018\u20132020), registered in four audits for pancreatic surgery from North America, Germany, Sweden, and The Netherlands. Patients who underwent concomitant arterial and\/or multivisceral resection(s) were excluded. Predictors for in-hospital\/30-day major morbidity and mortality were investigated by logistic regression, correcting for each audit.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 2924 patients after DP were included, of whom 241 patients (8.2%) underwent DP-PVR. Rates of major morbidity (24% vs. 18%; <jats:italic>p<\/jats:italic>\u2009=\u20090.024) and post-pancreatectomy hemorrhage grade B\/C (10% vs. 3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.041) were higher after DP-PVR compared with standard DP. Mortality after DP-PVR and standard DP did not differ significantly (2% vs. 1%; <jats:italic>p<\/jats:italic>\u2009=\u20090.542). Predictors for major morbidity were PVR (odds ratio [OR] 1.500, 95% confidence interval [CI] 1.086\u20132.071) and conversion from minimally invasive to open surgery (OR 1.420, 95% CI 1.032\u20131.970). Predictors for mortality were higher age (OR 1.087, 95% CI 1.045\u20131.132), chronic obstructive pulmonary disease (OR 4.167, 95% CI 1.852\u20139.374), and conversion from minimally invasive to open surgery (OR 2.919, 95% CI 1.197\u20137.118), whereas concomitant PVR was not associated with mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>PVR during DP for pancreatic adenocarcinoma in the pancreatic body is associated with increased morbidity, but can be performed safely in terms of mortality.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-024-15932-3","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T14:03:01Z","timestamp":1723212181000},"page":"8327-8339","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Surgical Outcome After Distal Pancreatectomy With and Without Portomesenteric Venous Resection in Patients with Pancreatic Adenocarcinoma: A Transatlantic Evaluation of Patients in North America, Germany, Sweden, and The Netherlands (GAPASURG)"],"prefix":"10.1245","volume":"31","author":[{"given":"Thomas F.","family":"Stoop","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Augustinus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bergthor","family":"Bj\u00f6rnsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Tingstedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodil","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Wolfgang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Johansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn W. 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He is co-principal investigator of a Boston Scientific-sponsored international multicenter study on the use of intraoperative pancreatoscopy of patients with intraductal papillary mucinous neoplasms (IPMN). Simone Augustinus, Bergthor Bj\u00f6rnsson, Bobby Tingstedt, Bodil Andersson, Christopher L. Wolfgang, Jens Werner, Karin Johansen, Martijn W.J. Stommel, Matthew H.G. Katz, Michael Ghadimi, Michael G. House, Poya Ghorbani, I. Quintus Molenaar, Roeland F. de Wilde, J. Sven D. Mieog, Tobias Keck, Ulrich F. Wellner, Waldemar Uhl, Marc G. Besselink, and Henry A. Pitt have no conflicts of interest to declare that may be relevant to the contents of this manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}