• Martin Loos, Arianeb Mehrabi, Ali Ramouz, Pietro Contin, Oliver Strobel, Beat P Müller-Stich, Andre L Mihaljevic, Markus K Diener, Martin Schneider, Christoph Berchtold, Mohammed Al-Saeedi, Benjamin Goeppert, Philipp Mayer, Manuel Feisst, Ulf Hinz, Markus A Weigand, Thilo Hackert, and Markus W Büchler.
• Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
• Ann. Surg. 2022 Dec 1; 276 (6): e896e904e896-e904.

ObjectiveThe aim of this study was to determine the role of GVC in mortality after TP.BackgroundData from a nationwide administrative database revealed that TP is associated with a 23% mortality rate in Germany. Methods: A total of 585 consecutive patients who had undergone TP (n = 514) or elective completion pancreatectomy (n = 71) between January 2015 and December 2019 were analyzed. Univariable and multivariable analyses were performed to identify risk factors for GVC and 90-day mortality. Results: GVC was observed in 163 patients (27.9%) requiring partial or total gastrectomy. Splenectomy (odds ratio 2.14, 95% confidence interval 1.253.80, P = 0.007) and coronary vein resection (odds ratio 5.49,95% confidence interval 3.19-9.64, P < 0.001) were independently associated with GVC. The overall 90-day mortality after TP was 4.1% (24 of 585 patients), 7.4% in patients with GVC and 2.8% in those without GVC ( P = 0.014). Of the 24 patients who died after TP, 12 (50%) had GVC.ConclusionGVC is a frequent albeit not well-known finding after TP, especially when splenectomy and resection of the coronary vein are performed. Adequate decision making for partial gastrectomy during TP is crucial. Insufficient gastric venous drainage after TP is life-threatening.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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