Evidence map›Paper›PMID 36368993›Full record

ArticleBMC surgery2022

Outcomes and risks in palliative pancreatic surgery: an analysis of the German StuDoQ|Pancreas registry.

Felix O Hofmann, Rainer C Miksch, Maximilian Weniger, Tobias Keck, Matthias Anthuber, Helmut Witzigmann, Natascha C Nuessler, Christoph Reissfelder, Jörg Köninger, Michael Ghadimi and 5 more

Open access · goldAbstract read
In one paragraph

Article in BMC surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. [Patient safety in palliative surgery].Chirurgie (Heidelberg, Germany) · 2025
    Review
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 1 country.

Felix O HofmannDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Rainer C MikschDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Maximilian WenigerDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Tobias KeckDepartment of Surgery, University Clinic Schleswig-Holstein Campus Luebeck, Luebeck, Germany.
Matthias AnthuberDepartment of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany.
Helmut WitzigmannDepartment of General and Visceral Surgery, Dresden-Friedrichstadt General Hospital, Dresden, Germany.
Natascha C NuesslerDepartment of General and Visceral Surgery, Munich Clinic Neuperlach, Munich Municipal Hospital Group, Munich, Germany.
Christoph ReissfelderDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Jörg KöningerDepartment of General Surgery, Klinikum Stuttgart, Stuttgart, Germany.
Michael GhadimiDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Detlef K BartschDepartment of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Marburg, Germany.
Werner HartwigDepartment of General, Visceral and Oncologic Surgery, Evangelisches Krankenhaus, Duesseldorf, Germany.
Martin K AngeleDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Jan G D'Haese *Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Jens Werner *Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany. Jens.Werner@med.uni-muenchen.de.
Ludwig-Maximilians-Universität München · DEEvangelisches Krankenhaus Düsseldorf · DEHeidelberg University · DEKlinikum Stuttgart · DEKrankenhaus Dresden-Friedrichstadt · DEMünchen Klinik · DEPhilipps University of Marburg · DEUniversity Hospital Augsburg · DEUniversity of Lübeck · DE

Funding

Deutsche Forschungsgemeinschaft 401299842
6 · The paper itself

Abstract

backgroundNon-resectability is common in patients with pancreatic ductal adenocarcinoma (PDAC) due to local invasion or distant metastases. Then, biliary or gastroenteric bypasses or both are often established despite associated morbidity and mortality. The current study explores outcomes after palliative bypass surgery in patients with non-resectable PDAC.

methodsFrom the prospectively maintained German StuDoQ|Pancreas registry, all patients with histopathologically confirmed PDAC who underwent non-resective pancreatic surgery between 2013 and 2018 were retrospectively identified, and the influence of the surgical procedure on morbidity and mortality was analyzed.

resultsOf 389 included patients, 127 (32.6%) underwent explorative surgery only, and a biliary, gastroenteric or double bypass was established in 92 (23.7%), 65 (16.7%) and 105 (27.0%). After exploration only, patients had a significantly shorter stay in the intensive care unit (mean 0.5 days [SD 1.7] vs. 1.9 [3.6], 2.0 [2.8] or 2.1 [2.8]; P < 0.0001) and in the hospital (median 7 days [IQR 4-11] vs. 12 [10-18], 12 [8-19] or 12 [9-17]; P < 0.0001), and complications occurred less frequently (22/127 [17.3%] vs. 37/92 [40.2%], 29/65 [44.6%] or 48/105 [45.7%]; P < 0.0001). In multivariable logistic regression, biliary stents were associated with less major (Clavien-Dindo grade ≥ IIIa) complications (OR 0.49 [95% CI 0.25-0.96], P = 0.037), whereas-compared to exploration only-biliary, gastroenteric, and double bypass were associated with more major complications (OR 3.58 [1.48-8.64], P = 0.005; 3.50 [1.39-8.81], P = 0.008; 4.96 [2.15-11.43], P < 0.001).

conclusionsIn patients with non-resectable PDAC, biliary, gastroenteric or double bypass surgery is associated with relevant morbidity and mortality. Although surgical palliation is indicated if interventional alternatives are inapplicable, or life expectancy is high, less invasive options should be considered.

Indexed as

Carcinoma, Pancreatic DuctalPancreatic NeoplasmsHumansPalliative CarePancreasRegistriesRetrospective StudiesBiliary bypassExplorative surgeryGastroenteric bypassPalliative surgeryPancreatic ductal adenocarcinomaRegistry analysis

Identifiers

PMID36368993
PMCPMC9652845
OpenAlexW4309046351

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.