Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries
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Sista, Federico; Schietroma, Mario; Spampinato, Marcello G; Garritano, Stefano; D'Ugo, Stefano; Marchese, Tiziana; Saladino, Edoardo; Cuticone, Giuseppe; Gullá, Nino; Recordare, Alfonso; Palumbo, Rubina; Giani, Alessandro; Ferrari, Giovanni; Mazzola, Michele; Dondossola, Daniele; Rossi, Giorgio; Caccamo, Lucio; Zerbi, Alessandro; Nappo, Gennaro; Montorsi, Marco; Coppa, Jorgelina; Busset, Michele Droz dit; Mazzaferro, Vincenzo; Troci, Albert; Frontali, Alice; Crespi, Michele; Baldi, Caterina; Benuzzi, Laura; Ferrara, Francesco; Stella, Marco; Capurso, Gabriele; Falconi, Massimo; Tamburrino, Domenico; Benedetto, Fabrizio Di; Magistri, Paolo; Ballarin, Roberto; Zanus, Giacomo; Brizzolari, Marco; Uggeri, Fabio; Gianotti, Luca; Cereda, Marco; Ferraro, Daniele; Iacomino, Alessandro; Ferraro, Daniele; Pisaniello, Donatella; Vennarecci, Giovanni; Pisaniello, Donatella; Rompianesi, Gianluca; Troisi, Roberto Ivan; Patrone, Renato; Belli, Andrea; Izzo, Francesco; Palaia, Raffaele; Gianpaolo, Marte; Maida, Pietro; Pasquale, Tammaro; Bassi, Domenico; Cillo, Umberto; Moletta, Lucia; Sperti, Cosimo; Serafini, Simone; Milanetto, Anna Caterina; Pasquali, Claudio; Tolin, Francesca; Gruppo, Mario; De Simoni, Ottavia; Buscemi, Salvatore; Marino, Marco V; Giuffrida, Mario; Dallavalle, Raffaele; Calabretto, Francesca; Cobianchi, Lorenzo; Pugliese, Luigi; Giardino, Alessandro; Butturini, Giovanni; Regi, Paolo; Kauffmann, Emanuele Federico ;Di Franco, Gregorio; Morelli, Luca ;Furbetta, Niccolò; Napoli, Niccolo' ;Boggi, Ugo ;Pinotti, Enrico; Montuori, Mauro; Giuliani, Antonio; Izzo, Maria Lucia; Zanini, Nicola; Veneroni, Luigi; Giordano, Marco; Palini, Gian Marco; Garulli, Gianluca; Vaccara, Vincenzo La; de Rose, Agostino Maria; Giuliante, Felice; Ardito, Francesco; Mingoli, Andrea; Sapienza, Paolo; Lapolla, Pierfrancesco; Petrucciani, Niccolo; Cossa, Alessandra; Coppola, Alessandro; Belloni, Elena; Nigri, Giuseppe; Tisone, Giuseppe; Angelico, Roberta; Manzia, Tommaso Maria; Caputo, Damiano; Saverio, Salomone Di; Porcu, Alberto; Perra, Teresa; Feo, Claudio; Deiana, Giulia; Sartarelli, Lodovico; Pisconti, Salvatore; Tonini, Valeria; Patrono, Damiano; Moro, Francesco; Grasso, Luca; Brolese, Alberto; Ciarleglio, Francesco; Marcucci, Stefano; Nistri, Cristina; Massani, Marco; Tommaso, Stecca; Galasso, Elisa; Zanus, Giacomo; Brizzolari, Marco; Romano, Maurizio; Rossi, Serena; Novello, Simone; Ferrero, Alessandro; Langella, Serena; Armentano, Serena; Russolillo, Nadia; Dario, Lorenzin; Intini, Sergio; Giovanni, Terrosu; Recordare, Alfonso Giovanni; Pirozzolo, Giovanni; Palumbo, Rubina; Calabrese, Francesco; Querini, Giorgio; Zonta, Sandro; Caneparo, Andrea; Giacometti, Marco; De Francesco, Maura; Balduzzi, Alberto; Guglielmi, Alfredo; Ruzzenente, Andrea; Iacono, Calogero; Poletto, Edoardo; Marchegiani, Giovanni; Isa, Giulia; Malleo, Giuseppe; Alaimo, Laura; Salvia, Roberto; Conci, Simone; Crinò, Stefano Francesco; Campagnaro, Tommaso; Frigerio, Isabella; De Marchi, Francesco; Bonomo, Michele; Napetti, Sara; Frontali, Alice; Chierici, Andrea; Cotsoglou, Christian; Gjoni, Elson; Paleino, Sissi; Granieri, Stefano; Hashimoto, Daisuke; Satoi, Sohei; Yamamoto, Tomohisa; Uemura, Kenichiro; Matsumoto, Ippei; Kamei, Keiko; Maehira, Hiromitsu; Tani, Masaji; Hirano, Satoshi; Nakamura, Toru; Asano, Toshimichi; Akahoshi, Keiichi; Tanabe, Minoru; Ishii, Takeshi; H Al Saffaf, Mohamed; Hamoud, Mohammad Al; Khattab, Rahaf; Alissawi, Subhi; Hassouneh, Anas; Al-Maadani, Basma; Alali, Mahmoud Bilal; Hmdan, Quasi Ahmad; Obed, Aiman; Nijadat, Dania; Al-Shami, Khayry; Al-shami, Manar; Mohsen, Maram; Al-Mallah, Rozana; Albaba, Safa'; Theab, Mohammad; Massadeh, Noor; Theab, Reem Abdelrahman Khader; Wardeh, Salah; Salahwardeh, null; Alissawi, Subhi Zahi; Mardini, Anas; Arabiyat, Hamza Ayman Abdelhalem; Arabiyat, Hamza; Al-Hyari, Abdelkareem; Ababneh, Hazim; Naffa', Mo'taz Fawzat; Buwaitel, Mohammad Musallam; Al-Mekhlafi, Ayat; Rababa, Hebah; Alzoubi, Mohammed; Khamees, Almuatasim; Abuleil, Amro; Almiani, Sari; Obeidat, Khaled; Amarin, Zouhair; Al-Samawi, Abdulaziz; Hammoud, Amr A Al; Hammad, H; Alkhadem, Maeen Ali; Mahafdah, Mahmoud R; AlSaffaf, Mohamed; Alsabah, Mohamed; Hani, Mohammad Bani; Hamoud, Mohammad A AL; Alzghoul, Mohammad W; Khattab, Rahaf N; Shumrakh, Saeed K; Rababah, Ansam; Alghazo, Heyam; Rababah, Tasneem; Khamees, Almu'Atasim; Awadi, Sajeda; Sharie, Sarah Al; Abdelnoor, Ahmad; Shaout, Duaa Mohammad; Omarieh, Qais; Abu-Ghazal, Sara Yassir; Abu-Ghazal, Sara; Shaout, Dua'A; Abughazal, Sara Yasser; Fakhradiyev, Ildar; Tanabayeva, Shynar; Saliev, Timur; Issabekov, Ibragim; Spatayev, Zhanat; Han, Ho-Seong; Jo, Yeongsoo; Plaudis, Haralds; Martinsone, Katrina Deja; Atstupens, Kristaps; Jawad, Mohamad; Khalife, Mohamad; Faraj, Walid Ghazi; Alowjali, Fatoom; Albaraesi, Mohammed N; Aldressi, Wafa; Benamwor, Aihab; Ali, Suhil Ben; Saleh, Suhil; Alshatshat, Abdulhadi; Younes, Eman; Younes, Eman; Ekhmaj, Reyad; Bahroun, Sumayyah; Bahroun, Sumayyah Ghayth; Ekhmaj, Reyad; Bahroun, Sumayyah Ghayth; Burgan, Dania; Aalem, Hajer Abd Alhamed; El Hussain, Ramadan Kamoka; Morgom, Marwa; Alshareea, Entisar; Ellafi, Amera Ali Dakheel; Shoukrie, Shoukrie; Shamakhi, Taha Mahmoud Omar; Bareig, Elham; Abusannuga, Malek; Dkhakhni, Abdulbari; Gerwash, Ahmed Abdualla; Gerwash, Ahmed; Zawia, Ali; Othman, Eman; Binnawara, Muhannud; Abdalsalam, Sabriya Juma Ali; Aljamal, Sarah; Ahmeed, Sultan; Khalil, Wegdan Ibrahim Almabrouk; Khalel, Wegdan; Faraj, Tasneem; Elhajdawe, Fras; Emhemed, Marwa; Salem, Osama; Abdulwahed, Eman; Khalil, Wegdan; Rhuma, Heba; Alsori, Mohamed; Mustafa, Tahani; Albarouni, Sofian; Albishti, Ahmed; Elhadi, Muhammed; Elkhuja, Taha; Msherghi, Ahmed; Hasan, Najat Shaban Ben; Hasan, Hayat Ben; Hasan, Najat Ben; Gulbinas, Antanas; Barauskas, Giedrius; Ignatavicius, Povilas; Riauka, Romualdas; Vanagas, Tomas; Slepavicius, Algirdas; Jurgaitis, Jonas; Dailidenas, Sarunas; Eismontas, Vitalijus; Mikutaitis, Vytenis; Šlepavičius, Algirdas; Jurgaitis, Jonas; Mikutaitis, Vytenis; Dulskas, Audrius; Kuliavas, Justas; Aniukstyte, Laura; Sileikis, Audrius; Gulla, Aiste; Šileikis, Audrius; Tumas, Jaroslav; Strupas, Kestutis; Petrulionis, Marius; Kvietkauskas, Mindaugas; Strupas, Kestutis; Vito, Deblasi; Rosso, Edoardo; Tan, Jih Huei; Zakaria, Andee Dzulkarnaen; Mohamad, Ikhwan Sani; Meng, Leow Voon; Huai, Teoh Zhan; Hayati, Firdaus; Sellappan, Harivinthan; Maiyauen, Thanesh Kumar; Azman, Azlanudin; Chik, Ian; Zuhdi, Zamri; Yoong, Boon; Soon, Koh Peng; Kit, Koong Jun; Yoong, Boon Koon; Koong, Jun Kit; Koh, Peng Soon; Ibrahim, Aini; Abdullah, Nik Azim Nik; Bong, Jin; Ghani, Shahi; Zorrilla, Carlos Florez; Cruz, Miguel Charco; Valladares, Andre Moguel; Dominguez-Rosado, Ismael; Rosciano, Alejandro Eduardo Padilla; Sebastian, Garcia-Herrera; Melchor-Ruan, Javier; Garcia-Herrera, Juan Sebastian; Sandag, Erdene; Erdene, Sarnai; Orgoi, Sergelen; Korch, Moniba; Boutti, Ahmed Sami; boumzebra, yassmine; Boumzebra, Yassmine; Hourri, Fatine; Gouazar, Iltimass; Belaid, Wafae Ait; Serji, Badr; Tarik, Bouhout; Tijani, El Harroudi; Zentar, Aziz; Ghannam, Abdelilah; Bounaim, Ahmed; Souadka, Amine; Benkabbou, Amine; El Ahmadi, Brahim; Amina, Houmada; Oumayma, Lahnaoui; Amrani, Laila; Majbar, Mohammed Anass; Mohsine, Raouf; Elhassouni, Reda; Echiguer, Sabrillah; Belkhadir, Zakaria; Nashidengo, Abdulrashid Pueya; Quayson, Francis; Abebrese, John; Nashidengo, Pueya; Adhikari, Krishna Mohan; Lakhey, Paleswan Joshi; Bhandari, Ramesh Singh; Besselink, Marc G; Bieze, Matthanja; Augustinus, Simone; Busch, Olivier; Pranger, B K; Hoogwater, F J H; Klaase, J M; Meerdink, M; Nijkamp, M W; de Meijer, VE; Koerkamp, Bas Groot; van Eijck, Casper HJ; Van Dam, Jacob L; Barbier, Louise; Johnston, Peter; Babor, Richard; Chu, Michael Jen Jie; Oliver, Tiffany; Wen, Daniel; Koea, Jonathan; Koea, Jonathan; Brown, Lisa; Srinivasa, Sanket; Bartlett, Adam; Windsor, John; Carr-Boyd, Peter; Bindra, Vanshay; Cross, Andrea; Connor, Saxon; Hore, Todd; Gunawardene, Ashok; Welsh, Fraser; Mahadik, Monique; Gordon, Alexandra; Rossaak, Jeremy; Adeyeye, Ademola; Enoch, Elizabeth; Kayode-Nissi, Victor; Abiyere, Henry; Alatise, Olusegun; Okomayin, Andrew; Odion, Clement; Tagar, Esteem; Sheshe, Abdulrahaman Abba; Muhammad, Abubakar Bala; Garzali, Ibrahim Umar; Ajayi, Peter; Kadri, Exhevit; Jabri, Salah Al; Azri, Yahya Al; Pal, Khuwaja Muahammad Inam; Siddiqui, Tayyab; Waqar, Usama; Waqar, Usama; Chaudhry, Ahmad Areeb; Abbasy, Jibran; Khan, Muhammad Osama; Shafqatullah, Syed; Khokhar, Muhammad Imran; Akbar, Ali; Afzal, Ameer; Asghar, Mohammad; Ullah, Sami; Butt, Usman Ismat; Butt, Usman; Bari, Hassaan; Mohammad, Bilal Nabil; Hameda, Mahmoud; Jayyab, Mustafa Abu; Alzabadiah, Asmaa Hasan Mohammad; Adam, Islam; Abuzaina, Khalil; Farid, Mohammad; Emar, Mohammad Farid Mohammad; Emar, Mohammad; Zreqat, Qusai; Titi, Rawand; Idkiedek, Sarah Ameen; Amro, Sarah; Al-Qasrawi, Shahd; Almasri, Tabarak Abedlnaser; Alnammourah, Walaa Mohammed; Kiswani, Gharam; Sinnokrot, Raghida; Harb, Zahrah Abu; Nafa'A, Hiba; Shtewi, Lyana; Salah, Abrar Omar; Joma, Aseef B A; Faraj, Sireen; Zitawi, Abdullah; Dawood, Ahmad Jamal; Saadeh, Ibraheem; Hmeedan, Alaa; Daraghmeh, Motaz Ayman Mahmoud; Janajreh, Amani Netham Atia; Manassra, Fatima; Yassin, Laya Moayyad Ahmed; Yassin, Raya; Saleh, Abrar Omar; Faraj, Sireen Mahmoud; Sulaiman, Abdallah S; Khayyat, Zain; Joma, Aseef B A; Shawahni, Eman; Salah, Abrar; khader, Abdullatef; Hammoudeh, Ahlam; Abdulhaq, Aram; Alawna, Reem; Roman, Gilbert; Targarona, Javier; Grau, Rafael Garatea; Molina, Raquel; Alegria, Cesar Rodriguez; Coayla, Guillermo; Enriquez, Juan Carlos Marcos; Marcos, Juan Carlos; Hasiman, Alyssa Nicole; Teh, Catherine; Cerdeño, Ruby; David, Avril; Sarmiento, Ray I; Barroso, Ryan Ruel; Alfonso, Cenon; Ang, Dr Dante; Casupang, Amornetta; Mamuric, Monica; Jardinero, Jose Mari; Motyka, Agata; Flisińska, Marta; Pierściński, Stanisław; Mrowiec, Slawomir; Rymarowicz, Justyna; Matyja, Maciej; Wikar, Tomasz; Sierzega, Marek; Pędziwiatr, Michał; Richter, Piotr; Durczynski, Adam; Kosztowny, Konrad; Ciesielski, Wojciech; Wardeszkiewicz, Aleksander; Szwedziak, Krzysztof; Wlazlak, Michal; Grzasiak, Oliwia; Szewczyk, Patrycja; Hogendorf, Piotr; Wyroślak-Najs, Justyna; Rawicz-Pruszyński, Karol; Sędłak, Katarzyna; Solecki, Michał; Polkowski, Wojciech; Słodkowski, Maciej; Wierzchowski, Michał; Korcz, Wojciech; Nazarewski, Lukasz; Kornasiewicz, Oskar; Lopes, Maria; Martins, Rui Miguel; Martins, Ruben; Vigia, Emanuel; Silva, Donzília Sousa; Davide, José; Pereira, Andre; Tenreiro, Nadia; Castro, Tiago; Eisa, Reem; Diaconescu, Bogdan; Ciubotaru, Cezar; Negoi, Ionut; Negoiţă, Valentina; Radulescu, Raluca Bievel; Bacalbaşa, Nicolae; Dima, Simona; Dumitrascu, Traian; Spanu, Andrada; Mardare, Mara; Ginghina, Octav; Catrina, Eduard; Brezean, Iulian; Misca, Mihaela; Vilcu, Mihaela; Aldoescu, Sorin; Petrea, Sorin; Bartos, Adrian; Liviu, Cioltean Cristian; Iancu, Ioana; Barbu, Sorin Traian; Bodea, Raluca; Mois, Emil; Florin, Graur; Hajjar, Nadim al; Matei, Sergiu; Zaharie, Florin; Scripcariu, Viorel; Musina, Ana-Maria; Roata, Cristian Ene; Dimofte, Gabriel Mihali; Velenciuc, Natalia; Lunca, Sorinel; Ong, Wee Liam; Ong, Wee Liam; Duta, Ciprian; Brebu, Dan; Braicu, Vlad; Belyaev, Alexander; Popov, Alexey; Batova, Anastasia; Katysheva, Anastasiia; Mizgirev, Denis; Neledova, Liudmila; Duberman, Boris; Litvin, Andrey; Pobelenko, Artem; Kuznetsov, Georgy; Khatkov, Igor; Tyutyunnik, Pavel; Izrailov, Roman; Bedzhanyan, Arkady; Petrenko, Konstantin; Bredikhin, Mikhail; Shatverian, Dr Garnik; Chardarov, Nikita; Bagmet, Nikolay; Lyadov, Vladimir; Mudryak, Daniil; Semenenko, Ivan; Tokarev, Mark; Kriger, Andrey; Kaldarov, Ayrat; Ivanov, Gennady; Kuchin, Denis; Torgomyan, Gaik; Zagainov, Vladimir; Davydkin, Vasili; Baranov, Andrey Igorevich; Drozdov, Evgeniy; Anatolievna, Li Natalya; Abdullaev, Abakar; Gachabayov, Mahir; Ghunaim, Mohammed; Alharthi, Mohammed; Aljiffry, Murad; Bogdanovic, Marko; Zivanovic, Marko; Bogdanovic, Aleksandar; Galun, Daniel; Dugalic, Vladimir; Arbutina, Dragana; Milic, Ljiljana; Bezmarevic, Mihailo; Antic, Andrija; Radenkovic, Dejan; Ignjatovic, Igor; Zdujic, Predrag; Kmezic, Stefan; Karamarkovic, Aleksandar; Arbutina, Dragana; Juloski, Jovan; Radulovic, Radisav; Radulović, Radosav; Cuk, Vladica; Jeremic, Ljiljana; Radojkovic, Milan; Stojanovic, Miroslav; Golijanin, Danica; Ignjatovic, Milana Kresoja; Protic, Mladjan; Chiow, Adrian; Seng, Lee Lip; Thiruchelvam, Nita; Poh, Brian Goh Kim; Goh, Brian K P; Quan, Darren Chua Wei; Koh, Ye Xin; TrotovŠek, Blaž; Petrič, Miha; Djokić, Mihajlo; Tomazic, Ales; Badovinac, David; Loots, Emil; Prodehl, Leanne; Khan, Mohammed Uzayr; Marumo, Thomas; Devar, John WS; Omoshoro-Jones, Jones; Khan, Zafar A; Jugmohan, Ben; Valcarcel, Ana Quiroga; García, Belén Matías; Mínguez, Javier; Marcello, Manuel; Ramia, Jose; Compañ, Antonio; Fernandes, Carlos; Morales, Miguel; Fernández, Jose Miguel Vargas; Del Mar Rico-Morales, Maria; Liñán, Miguel ángel Lorenzo; Figueras, Joan; Soliva, Ramon; Butori, Eugenia; Fondevila, Constantino; Ausania, Fabio; Martín, Belén; Rodríguez, Manuel; Sánchez-Cabús, Santiago; Sánchez-Velázquez, Patricia; Arnau, Ana Belen Martin; Domínguez, Ramón Soliva; Ielpo, Benedetto; Pinilla, Fernando Burdío; Castro, Maria; Valverde, David Padilla; Santos, Esther Pilar García; del Carmen Manzanares Campillo, María; Ruiz, Patricia; Gutierrez, Ernesto Castro; Falgueras, Laia; Quer, Maria Teresa Albiol; Shwely, Farah Al; Fragua, Raquel Latorre; Gonzalez-Serna, Daniel Bejarano; Valmorisco, Marcos Alba; Beltran-Miranda, Pablo; Busquets, Juli; Secanella, Lluis; Pelaez, Nuria; Plaza, Gabriel; Duaigües, Marta Lourdes Gonzalez; álvarez, Pablo Muriel; Escartín, Alfredo; Loinaz, Carmelo; Dziakova, Jana; de la Serna, Sofia; Pérez-Aguirre, Elia; Justo, Iago; Saavedra, Jorge; Gomez, Jose Castell; Boñar, Nuria Losa; Martín-Perez, Elena; Di Martino, Marcello; de la Hoz Rogriguez, ángela; Marcacuzco, Alberto; Jiménez-Romero, Carlos; de la Rúa, Jorge F Roldán; Hinojosa-Arco, Luis C; Suárez-Muñoz, Miguel ángel; Martinez, David Ferreras; Sanchez-Bueno, Francisco; Vazquez, Pedro Gil; de León, Alberto Miyar; Saiz, Elisa Contreras; García, Lorena Solar; Gonzalez-Pinto, Ignacio; Rodríguez-Pino, José Carlos; Segura-Sampedro, Juan José; Morales, Rafa; Morales-Soriano, Rafael; Rotellar, Fernando; Zozaya, Gabriel; Martí-Cruchaga, Pablo; López-Sánchez, Jaime; Muñoz-Bellvis, Luis; Cuadrado, Angel; ortega, Irene; Fernández, Rocio; Gómez, Daniel Díaz; Vera, Valle; Padillo, Javier Padillo; Luque, Juan Bellido; Millan, Erik Ilacer; Jorba, Rosa; García-Domingot, María Isabel; Redondo, Carlos; Cantos, Dra Míriam; Artigues, Enrique; Pozo, Carlos Domingo-Del; Llorente, Carmen Payá; Martínez, Sergio Navarro; Ibáñez, Cristina Ballester; Ibáñez, Javier Maupoey; Andujar, Rafael López; Dorcaratto, Dimitri; Forner, Elena Muñoz; Garces-Albir, Marina; de Heredia, Juan Beltran; Montes-Manrique, Mario; Rodriguez-Lopez, Mario; Serrablo, Alejandro; Milian, Daniel; Ruiz-Quijano, Pablo; Paterna-Lopez, Sandra; Dharmapala, Arinda; Dassanayake, B K; Galketiya, K B; Ibrahim, Ahmed Mohamed; Hamid, Hytham; Alhaboob, Nassir; Abdelmageed, Abdelfatah; Taha, Samah Suliman Osman; Vilhav, Caroline; Wennerblom, Johanna Hansson; Bratlie, Svein Olav; Bjornsson, Bergthor; Lundgren, Linda; Sandström, Per; Tingstedt, Bobby; Andersson, Roland; Andersson, Bodil; Williamsson, Caroline; Sparrelid, Ernesto; Holmberg, Marcus; Ghorbani, Poya; Gkekas, Ioannis; Kuemmerli, Christoph; Bolli, Martin; Andreou, Andreas; Wenning, Anna Silvia; Gloor, Beat; Peloso, Andrea; Toso, Christian; Oldani, Graziano; Moeckli, Beat; Wassmer, Charles-Henri; Cristaudi, Alessandra; Pietro, Majno-Hurst; Majno-Hurst, Pietro Edoardo; Roesel, Raffaello; Abbassi, Fariba; Tarantino, Ignazio; Steffen, Thomas; Ferrari, Carlo; Schmidt, Jan; Meier, Olga; Weber, Markus; Gutknecht, Stefan; Jonas, Jan Philipp; Clavien, Pierre-Alain; Al-Haj, Ahmad; Aljaber, Ahmad; Kayali, Ahmad Amir; Kadoura, Lama; Nashed, Ezzeldin; Helaly, Hala; Kayali, Hasan; Alhashemi, Mais; Aloulou, Marwa; Alshaghel, Mohammed; Mahli, Nihad; Al-Abed, Omar; Azizeh, Oula; Torab, Sana Shaikh; Alkhaleel, Wael; Aliwy, Marwan Al; Alannaz, Omar; Ghazal, Ahmad; Masri, Ruqaya; Douba, Zain; Saad, Ahmed Saeed; Abdulmonem, Aya; Shaban, Mahmoud; Alhouri, Ahmad Nabil; Alhouri, Ahmad; Soliman, Alnour; Houri, Hasan Nabil Al; Houri, Hasan Al; Omran, Sarah; Abbas, Aram; Chaaban, Majd; Kudmani, Mhd Adib Al; Chaaban, Mohammad Karam; Alhmaidi, Riad; Yousef, Amal; Youssef, Amal; Nasri, Muhammad; Alkhateb, Hossain; Almjersah, Abdulrahman; Hassan, Naya; Moussa, Ahmed; Hamdan, Alaa; Hammed, Ali; Alloush, Ali; Hassan, Bashar Haj; Issa, Hala; Dahhan, Hiba Talal; Souliman, Mahmoud; Hammed, Salah; Tobba, Tharaa Mehdi; Hamdan, Alaa; Ayoub, Seba; Yu, Ming-Chin; Yang, Po-Chih; Wu, Chien Hui; Bouaziz, Hanen; Rahal, Khaled; Slim, Skander; Karim, Ayed; Baraket, Oussama; Kchaou, Ali; Houssem, Ammar; Said, Mohamed Amine; Mabrouk, Mohamed Ben; Hamida, Karim Ben; Ghalleb, Montassar; Mahmoud, Ahmed Ben; Maghrebi, Houcine; Kacem, Montasser Jameleddine; Tez, Mesut; Eminesariipek, N; çetiindağ, özhan; Tüzüner, Acar; Karayalçin, Kaan; Emral, Ahmet Cihangir; Dikmen, Kursat; Kerem, Mustafa; Bayhan, Hüseyin; Türkoğlu, Mehmet Akif; Iflazoğlu, Nidal; özet, Ahmet; Aday, Ulaş; öfkeli, özcem; Gumusoglu, Alpen; Kabuli, Hamit Ahmet; Karabulut, Mehmet; Peker, Kivanc; Saglam, Sezer; Rahimi, Fatema Sayed İsmail; Hanefa, Fatema; Isik, Arda; Goksoy, Ertugrul; Dulundu, Ender; Atici, Ali Emre; Ozocak, Aysegul Bahar; Yegen, Cumhur; Dural, Ahmet Cem; Sahbaz, Nuri Alper; Ulgur, Hanife Seyda; Aydin, Husnu; Ozkan, Omer Faruk; Duzgun, Ozgul; çelik, Muhammet; Pekmezci, Salih; çoker, Ahmet; Uguz, Alper; Unalp, Omer Vedat; Sert, Ismail; Ertekin, Suleyman; Ozbilgin, Mucahit; Aydoğan, Serdar; Tekin, Enver; Calik, Bulent; Yesilyurt, Degercan; Atici, Semra Demirli; Arıkan, Türkmen Bahadır; Arıkan, Turkmen; Gonullu, Emre; Dikicier, Enis; Capoglu, Recayi; Bayhan, Zulfu; Alfurais, Sarah; Colak, Elif; Polat, Suleyman; Çiftci, Ahmet Burak; Milburn, James; Jones, Claire; Vass, David; Taylor, Mark; Dasari, Bobby VM; Kausar, Ambareen; Sultana, Asma; Subar, Daren; 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Ghushaim, Mohammed; Sabbar, Mohammed; Esmail, Muhib; Ali, Ramzi Abdullah Yahya; Salem, Rana Hassan Mohammed; Salem, Rana; Saif, Wail; Al-Faiq, Siham; Alsharabi, Ebrahim; Hameed, Almekhlafi Tofik Abdul; Almekhlafi, Tofik; Omairan, Abdulrahman; Almarkiz, Eman; Abduljawad, Heba; Mansaleh, Omair; Al-Melhani, Watheeq; Abdualqader, Mahmmoud; Al-Abdi, Radfan; Alwan, Hussein Mohammed; Mbanje, Chenesa; Chihaka, Onesai
2024-01-01
Abstract
Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
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