Real-world short-term outcomes after distal pancreatectomy with en bloc celiac axis resection using the National clinical database of Japan

Surg Today. 2025 Nov 19. doi: 10.1007/s00595-025-03170-3. Online ahead of print.

ABSTRACT

PURPOSE: To identify the risk factors for mortality and morbidity after distal pancreatectomy with en bloc celiac axis resection (DP-CAR) using prospectively registered data from the National Clinical Database (NCD).

METHODS: We retrospectively analyzed patients registered in the NCD between 2018 and 2021 who underwent DP-CAR. Surgical morbidity, mortality, and associated clinical factors were evaluated.

RESULTS: The study included 136 patients. Preoperative therapy included chemotherapy in 110 (80.9%) patients. The surgical mortality rate was 2.2% (3/136 patients). Recent weight loss (≥ 10% in the past 6 months) was significantly more prevalent in the mortality group than in the non-mortality group (33.3% [1/3] vs. 4.5% [6/133], respectively). Clavien-Dindo grade ≥ III complications occurred in 34.6% of the patients. Age ≥ 80 years old (odds ratio [OR], 8.75; 95% confidence interval [CI]: 1.21-63.43; p = 0.032) and portal vein resection (OR, 2.72; 95% CI: 1.04-7.13; p = 0.042) were identified as potential risk factors for severe postoperative complications. Recent weight loss (OR, 5.18; 95% CI: 0.96-27.8; p = 0.055) approached statistical significance.

CONCLUSION: Although specific mortality risk factors could not be identified, the low mortality rate suggests that DP-CAR is safely performed in Japanese practice. Future efforts should focus on achieving zero DP-CAR-associated mortality.

PMID:41258484 | DOI:10.1007/s00595-025-03170-3