ArticleAnnals of surgery2026
Who Do We Fail to Rescue After Pancreatoduodenectomy? Outcomes Among >4000 Procedures Expose Windows of Opportunity.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Predictive Value of the ALBI Grade for Short-Term Morbidity and Mortality After Pancreatoduodenectomy.Cancers · 2026Article
- When and how can in-hospital deaths following pancreaticoduodenectomy be prevented?Gland surgery · 2026Article
- Impact of age on safety of pancreaticoduodenectomy: a nationwide cohort study stratified by surgical approach and anastomotic technique with optimal age cut-off analysis.Science China. Life sciences · 2026Article
- Area-based centralization of pancreatic surgery: a Hub-and-Spoke system balances patient proximity and quality of care.Updates in surgery · 2026Article
- Impact of preoperative internal versus external biliary drainage on surgical and oncological outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Article
- Self-Inflicted Wound: Spontaneous Pancreatic Duct Stent Migration Into Hepatic Parenchyma.ACG case reports journal · 2026Article
- New implications from long-term outcomes of perioperative therapy in resectable pancreatic cancer.British journal of cancer · 2026Review
- Biomaterials in pancreatic surgery: progress and challenges in preoperative, intraoperative and postoperative care.Theranostics · 2026Review
- Severe morbidity following pancreatectomy with vascular reconstruction: impact of intraoperative vascular events and grafted venous reconstructions.Surgery in practice and science · 2025Article
- Review
- Mortality patterns and postoperative outcomes of trauma-induced pancreatic resections: A pilot study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025Article
- Trends in the Outcomes of Advanced Hepatobiliary-Pancreatic Surgery: The Impact of a Nationwide Clinical Database and Surgeon Certification System.Journal of hepato-biliary-pancreatic sciences · 2025Article
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14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveOur investigation on in-hospital mortality after 4474 pancreatoduodenectomies aimed to identify time-dependent risks as well as windows of opportunity to rescue patients from complications.
backgroundPancreatoduodenectomy is generally considered a safe procedure with a 1% to 10% perioperative mortality based on complexity and surgical volume. Yet, patients are susceptible to life-threatening complications particularly with extended resections. Recognition of distinct vulnerabilities over time while patients recover is required to permit focused monitoring, sophisticated resource allocation, and the greatest surgical safety.
methodsPatients who deceased in-hospital after pancreatoduodenectomy between 2003 and 2021 were retrieved from the institutional pancreatectomy registry and analyzed in detail with respect to their postoperative course.
resultsAmong 4474 pancreatoduodenectomies, 156 patients deceased in-hospital (3.5%). When assessing root causes of mortality, we observed 3 different clusters of complications, which were postpancreatectomy-specific (51.9%), visceral vasculature-associated (25.6%), or cardiopulmonary in origin (17.9%). The median times of root cause onset in the 3 categories were postoperative day (POD) 9, POD 4.5 ( P =0.008), and POD 3 ( P <0.001), respectively. Medians of in-hospital mortality were POD 31, POD 18 ( P =0.009), and POD 8 ( P <0.001). Intervals between root cause onset and mortality varied with medians of 23 days, 11 days ( P =0.017), and 1 day ( P <0.001). The 3 categories were similarly distributed between different types of surgical complexity.
conclusionsPostpancreatectomy-specific complications prompt almost half of the in-hospital mortalities after pancreatoduodenectomy, with rather long intervals for interventions to prevent failure to rescue. In contrast, visceral vasculature-related events and cardiopulmonary complications dominate early in-hospital mortalities with short intervals until mortality, demanding rigorous management of such events or preoperative conditioning. These data externally validate a previous high-volume initiative and highlight distinct windows of opportunity to optimize perioperative safety.
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