PMID- 33521900
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20210721
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Print)
IS  - 1068-9265 (Linking)
VI  - 28
IP  - 8
DP  - 2021 Aug
TI  - Complications After Major Surgery for Duodenopancreatic Neuroendocrine Tumors in 
      Patients with MEN1: Results from a Nationwide Cohort.
PG  - 4387-4399
LID - 10.1245/s10434-020-09496-1 [doi]
AB  - BACKGROUND: Little is known about complications after major duodenopancreatic 
      surgery for duodenopancreatic neuroendocrine tumors (dpNETs) in multiple 
      endocrine neoplasia type 1 (MEN1). Therefore, the incidence and severity of 
      complications after major surgery for MEN1-related dpNETs were assessed. METHODS: 
      Patients were selected from the population-based Dutch MEN1 database if they had 
      undergone a Whipple procedure or total pancreatectomy from 2003 to 2017. 
      Complications were graded according to the Clavien-Dindo classification (grade 
      III or higher complications were considered a severe complication) and 
      definitions from the International Study Group of Pancreatic Surgery. The 
      Cumulative Complication Index (CCI((R))) was calculated as the sum of all 
      complications weighted for their severity. Univariable logistic regression was 
      performed to assess potential associations between predictor candidates and a 
      severe complication. RESULTS: Twenty-seven patients (median age 43 years) 
      underwent a major duodenopancreatic resection, including 14 Whipple procedures 
      and 13 total pancreatectomies. Morbidity and mortality were 100% (27/27) and 4% 
      (1/27), respectively. A severe complication occurred in 17/27 (63%) patients. The 
      median CCI((R)) was 47.8 [range 8.7-100]. Grade B/C pancreatic fistulas, delayed 
      gastric emptying, bile leakage, hemorrhage, and chyle leakage occurred in 7/14 
      (50%), 10/27 (37%), 1/27 (4%), 7/27 (26%), 3/27 (11%) patients, respectively. 
      Patients with a severe complication had longer operative time and higher blood 
      loss. After Whipple, new-onset endocrine and exocrine insufficiency occurred in 
      1/13 and 9/14 patients, respectively. CONCLUSIONS: Major duodenopancreatic 
      surgery in MEN1 is associated with a very high risk of severe complications and 
      cumulative burden of complications and should therefore be reserved for a select 
      subgroup of patients with MEN1-related dpNETs.
FAU - van Beek, Dirk-Jan
AU  - van Beek DJ
AUID- ORCID: 0000-0001-7834-8128
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Nell, Sjoerd
AU  - Nell S
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Vorselaars, Wessel M C M
AU  - Vorselaars WMCM
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Bonsing, Bert A
AU  - Bonsing BA
AD  - Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
FAU - van Eijck, Casper H J
AU  - van Eijck CHJ
AD  - Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
FAU - van Goor, Harry
AU  - van Goor H
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The 
      Netherlands.
FAU - Nieveen van Dijkum, Elisabeth J
AU  - Nieveen van Dijkum EJ
AD  - Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC Academic Medical 
      Center, Amsterdam, The Netherlands.
FAU - Dejong, Cornelis H C
AU  - Dejong CHC
AD  - Department of Surgery, Maastricht University Medical Center, NUTRIM School for 
      Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
AD  - Department of Surgery, Universitatsklinikum Aachen, Aachen, Germany.
FAU - Valk, Gerlof D
AU  - Valk GD
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The 
      Netherlands.
CN  - DutchMEN Study Group (DMSG)
FAU - Borel Rinkes, Inne H M
AU  - Borel Rinkes IHM
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands.
FAU - Vriens, Menno R
AU  - Vriens MR
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, The Netherlands. mvriens@umcutrecht.nl.
LA  - eng
PT  - Journal Article
DEP - 20210131
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Multiple Endocrine Neoplasia Type 1/surgery
MH  - *Neuroendocrine Tumors/surgery
MH  - Pancreatectomy
MH  - *Pancreatic Neoplasms/surgery
MH  - Pancreaticoduodenectomy/adverse effects
PMC - PMC8253708
FIR - Bisschop, P H
IR  - Bisschop PH
FIR - Dekkers, O M
IR  - Dekkers OM
FIR - Drent, M L
IR  - Drent ML
FIR - Havekes, B
IR  - Havekes B
FIR - de Herder, W W
IR  - de Herder WW
FIR - van der Horst-Schrivers, A N A
IR  - van der Horst-Schrivers ANA
FIR - Pieterman, C R C
IR  - Pieterman CRC
FIR - van de Ven, A C
IR  - van de Ven AC
EDAT- 2021/02/02 06:00
MHDA- 2021/07/09 06:00
PMCR- 2021/01/31
CRDT- 2021/02/01 06:05
PHST- 2020/09/18 00:00 [received]
PHST- 2020/12/01 00:00 [accepted]
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
PHST- 2021/02/01 06:05 [entrez]
PHST- 2021/01/31 00:00 [pmc-release]
AID - 10.1245/s10434-020-09496-1 [pii]
AID - 9496 [pii]
AID - 10.1245/s10434-020-09496-1 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2021 Aug;28(8):4387-4399. doi: 10.1245/s10434-020-09496-1. Epub 
      2021 Jan 31.