ArticleWorld journal of surgery2022
Long-Term Outcome of Patients with Postoperative Refractory Diarrhea After Tailored Nerve Plexus Dissection Around the Major Visceral Arteries During Pancreatoduodenectomy for Pancreatic Cancer.
Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Radicality and safety of total mesopancreatic excision in pancreatoduodenectomy: a systematic review and meta-analysis.World journal of surgical oncology · 2024Pooled it
- Article
- Surgical Challenges Associated with Collateral Veins Formation in Pancreatic Cancer with Vein Resection.Annals of surgical oncology · 2026Article
- Diagnostic and therapeutic challenges with malignant biliary tract and periampullary pathology in post-bariatric surgery.Frontiers in surgery · 2026Review
- Diarrhea after pancreatic surgery is associated with the extent of resection: a single-center retrospective cohort-study.Langenbeck's archives of surgery · 2025Article
- Deep learning to predict extrapancreatic perineural invasion at CT images.Annals of medicine · 2025Article
- Comparison of Total Mesopancreatic Excision and Conventional Pancreaticoduodenectomy in the Surgical Treatment of Pancreatic Head Adenocarcinoma: Early Postoperative Outcomes.Medicina (Kaunas, Lithuania) · 2025Article
- Postoperative Refractory Diarrhea After Margin Accentuation of the Superior Mesenteric Artery with Irreversible Electroporation in Pancreaticoduodenectomy.Journal of clinical medicine · 2025Article
- Article
- Arterial resection and divestment in pancreatic cancer surgery in the era of multidisciplinary treatment: decadal comparative study.BJS open · 2025Article
- Two Cases of Refractory Diarrhea Subsequent to Vascular Reconstruction for Infective Superior Mesenteric Artery Aneurysms.Annals of vascular diseases · 2024Article
- Development of the multiple scope transition method in robotic pancreaticoduodenectomy.Surgical endoscopy · 2024Article
- Comparison of prognosis and postoperative morbidities between standard pancreaticoduodenectomy and the TRIANGLE technique for resectable pancreatic ductal adenocarcinoma.World journal of gastrointestinal surgery · 2024Article
- Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies: A high-volume single-center experience with short-term outcomes.Annals of hepato-biliary-pancreatic surgery · 2024Article
- Extended lymphadenectomy based on the TRIANGLE for pancreatic head cancer: a single-center experience.Langenbeck's archives of surgery · 2024Article
- Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2024Review
- New approach of circumferential lymph node dissection around the superior mesenteric artery for pancreatic cancer during pancreaticoduodenectomy (with video).Langenbeck's archives of surgery · 2023Article
- Impact of para aortic lymph node removal on survival following resection for pancreatic adenocarcinoma.BMC surgery · 2023Article
- Clinical Efficacy of Neoadjuvant Chemotherapy with Gemcitabine plus S-1 for Resectable Pancreatic Ductal Adenocarcinoma Compared with Upfront Surgery.Annals of surgical oncology · 2023Article
- Technical options in surgery for artery-involving pancreatic cancer: Invasion depth matters.Surgery open science · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor pancreatic ductal adenocarcinoma (PDAC) surgery, extended dissection of the nerve plexus (pl) around the superior mesenteric artery (SMA) or celiac artery (CA) is sometimes necessary. This consequently results in postoperative refractory diarrhea. This study aimed to evaluate the clinical impact of extended nerve plexus dissection around major arteries on postoperative diarrhea.
methodsPatients who underwent pancreatoduodenectomy (PD) for PDAC between January 2013 and December 2016 were included. The frequency of diarrhea (defined as a condition requiring opioid antidiarrheal drug for at least 6 months after surgery) and its short- and long-term outcomes were reviewed.
resultsOf 200 consecutive patients who underwent PD, 78 (39.0%) developed postoperative refractory diarrhea (diarrhea group), and 73 of them (93.6%) underwent hemi-circumferential or more nerve dissection for SMA or CA; both plSMA and plCA dissection were associated with diarrhea. Borderline resectable artery (BR-A) PDAC was included more in the diarrhea group (32.0% vs. 13.1%, P = 0.001); however, the local recurrence rate in the diarrhea group was significantly lower than that in the non-diarrhea group (14.1% vs. 26.2%, P = 0.036). The completion of adjuvant chemotherapy and overall survival were comparable between the two groups. The pre-albumin level improved in 2 years, and 61.3% of patients with diarrhea could stop opioid antidiarrheal drugs within 3 years of surgery.
conclusionsAlthough the frequency of diarrhea increased following nerve plexus dissection around arteries, diarrhea was controllable and resulted in a reduced local recurrence rate. Aggressive dissection of the nerve plexus may be justified for local disease control in BR-A PDAC.
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