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Войти в исследования HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Impact of neoadjuvant chemotherapy on the rate of clinically significant postoperative pancreatic fistula.
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Saeidishahri Sara, Ebadinejad Amir, Serrano Oscar K
Аннотация
BACKGROUND: While numerous studies have evaluated predictors of postoperative pancreatic fistula (POPF) after pancreatectomy, limited data exist regarding the impact of neoadjuvant chemotherapy (NAC) on POPF among patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the association between NAC and POPF using a contemporary national cohort.
METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program pancreatectomy-targeted datasets for 2022 and 2023. NAC was defined as chemotherapy within 90 days before surgery. Univariate and multivariable logistic regression analyses were performed, adjusting for demographic, clinical, and operative covariates.
RESULTS: A total of 7,260 patients with PDAC were included; 48.2% received NAC and 10.3% received neoadjuvant radiation. 79.7% of patients underwent pancreaticoduodenectomy. Compared with non-NAC patients, those receiving NAC were younger and had higher rates of hard gland texture and intraoperative vascular resection. The incidence of POPF was significantly lower in the NAC group (7.2% vs. 12.6%, p < 0.001). On multivariable analysis, NAC remained independently associated with lower odds of POPF (adjusted OR 0.63, 95% CI 0.53-0.76, p < 0.001).
CONCLUSION: NAC is significantly associated with lower POPF incidence after resection for PDAC.
METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program pancreatectomy-targeted datasets for 2022 and 2023. NAC was defined as chemotherapy within 90 days before surgery. Univariate and multivariable logistic regression analyses were performed, adjusting for demographic, clinical, and operative covariates.
RESULTS: A total of 7,260 patients with PDAC were included; 48.2% received NAC and 10.3% received neoadjuvant radiation. 79.7% of patients underwent pancreaticoduodenectomy. Compared with non-NAC patients, those receiving NAC were younger and had higher rates of hard gland texture and intraoperative vascular resection. The incidence of POPF was significantly lower in the NAC group (7.2% vs. 12.6%, p < 0.001). On multivariable analysis, NAC remained independently associated with lower odds of POPF (adjusted OR 0.63, 95% CI 0.53-0.76, p < 0.001).
CONCLUSION: NAC is significantly associated with lower POPF incidence after resection for PDAC.