The following is a summary of “Morbidity and Mortality of Non-pancreatectomy operations for pancreatic cancer: An ACS-NSQIP analysis,” published in the FEBRUARY 2023 issue of Surgery by Adams, et al.

Patients with pancreatic cancer often require palliative procedures like a gastrointestinal or biliary bypass. However, there was a lack of recent studies comparing the postoperative outcomes of these procedures.

The study used data from the American College of Surgeons National Surgical Quality Improvement Program from 2005-2019 to analyze patients undergoing exploration, gastrojejunostomy, biliary bypass, or double bypass for pancreatic cancer. The study used multivariable regression models to compare 30-day mortality and complications across different procedures and time periods (2005-10, 2011-14, 2015-19). The study also identified factors associated with postoperative mortality.

Of 43,525 patients who underwent surgery with a postoperative diagnosis of pancreatic cancer, 5,572 met the inclusion criteria. The palliative operations included 1,037 gastrojejunostomies, 792 biliary bypasses, 650 double bypasses, and 3093 explorations. The proportion of biliary and double bypass procedures decreased from 2005-10 to 2015-19. Gastrojejunostomy had a higher 30-day mortality rate (11.5%) than other operations (P < 0.001). However, adjusted 30-day mortality rates remained stable over time (7.8% vs. 6.3%, P = 0.095), while rates of serious complications decreased over time (23.2% vs 17.1%, P < 0.001).

This study suggests that The 30-day mortality and complication rates with palliative bypass for pancreatic cancer have not decreased over time, and they are still high.

Source: americanjournalofsurgery.com/article/S0002-9610(22)00509-8/fulltext