• Eduard Antonie van Bodegraven, Sanne Lof, Leia Jones, Béatrice Aussilhou, Gao Yong, Wei Jishu, Rosa Klotz, Dario Missael Rocha-Castellanos, Ippei Matsumato, Charles de Ponthaud, Kimitaka Tanaka, Esther Biesel, Emmanuele Kauffmann, Traian Dumitrascu, Yuichi Nagakawa, Pablo Martí-Cruchaga, Geert Roeyen, Alessandro Zerbi, Mara Goetz, Vincent de Meijer, Patrick Pessaux, Povilas Ignatavicius, Ihsan Demir, Mario Giuffrida, Bobby Tingstedt, Marco Vito Marino, Sotiris Mastoridis, Maximilian Brunner, Isabel Mora-Oliver, Cecilia Bortolato, Aisté Gulla, Thomas Apers, Hélène Hermand, Yusuke Mitsuka, Irinel Popescu, Ugo Boggi, Uwe Wittel, Satoshi Hirano, Sébastien Gaujoux, Keiko Kamei, Carlos Fernández-Del Castillo, Thilo Hackert, Jiang Kuirong, Miao Yi, Alain Sauvanet, Marc Besselink, Mohammad Abu Hilal, Safi Dokmak, and European Consortium on Minimally Invasive Pancreatic Surgery and the International Consortium on Minimally Invasive Pancreatic Surgery.
• Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
• Ann. Surg. 2023 Dec 11.

ObjectiveTo develop a prediction model for major morbidity and endocrine dysfunction after CP which could help in tailoring the use of this procedure.Summary Background DataCentral pancreatectomy (CP) is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and pre-malignant tumors in body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared to distal pancreatectomy but it is thought to increase the risk of short-term complications including postoperative pancreatic fistula (POPF).MethodsInternational multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010-2021). Primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk model were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation.Results838 patients after CP were included (301 (36%) minimally invasive) and major morbidity occurred in 248 (30%) patients, POPF B/C in 365 (44%), and 30-day mortality in 4 (1%). Endocrine dysfunction in 91 patients (11%) and use of pancreatic enzymes in 108 (12%). The risk model for major morbidity included male sex, age, BMI, and ASA score≥3. The model performed acceptable with an area under curve (AUC) of 0.72(CI:0.68-0.76). The risk model for endocrine dysfunction included higher BMI and male sex and performed well (AUC:0.83 (CI:0.77-0.89)).ConclusionsThe proposed risk models help in tailoring the use of CP in patients with symptomatic benign and premalignant lesions in the body and neck of the pancreas and are readily available via www.pancreascalculator.com.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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