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Norman KS, Domingo SR, Wong LL. Pancreatic resections in renal failure patients: is it worth the risk?. HPB Surg. 2014;2014:938251doi: 10.1155/2014/938251.
Norman, K. S., Domingo, S. R., & Wong, L. L. (2014). Pancreatic resections in renal failure patients: is it worth the risk?. HPB surgery : a world journal of hepatic, pancreatic and biliary surgery, 2014938251. https://doi.org/10.1155/2014/938251
Norman, K S, et al. "Pancreatic resections in renal failure patients: is it worth the risk?." HPB surgery : a world journal of hepatic, pancreatic and biliary surgery vol. 2014 (2014): 938251. doi: https://doi.org/10.1155/2014/938251
Norman KS, Domingo SR, Wong LL. Pancreatic resections in renal failure patients: is it worth the risk?. HPB Surg. 2014;2014:938251. doi: 10.1155/2014/938251. Epub 2014 Feb 09. PMID: 24672144; PMCID: PMC3941119.
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HPB Surg. 2014;2014:938251. doi: 10.1155/2014/938251. Epub 2014 Feb 09.

Pancreatic resections in renal failure patients: is it worth the risk?.

HPB surgery : a world journal of hepatic, pancreatic and biliary surgery

K S Norman, S R Domingo, L L Wong

Affiliations

  1. Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA.
  2. Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA ; Queens Medical Center, Honolulu, HI 96813, USA.
  3. Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USA ; University of Hawaii Cancer Center, Honolulu, HI 96813, USA.

PMID: 24672144 PMCID: PMC3941119 DOI: 10.1155/2014/938251

Abstract

Background. Chronic kidney disease affects 20 million US patients, with nearly 600,000 on dialysis. Long-term survival is limited and the risk of complex pancreatic surgery in this group is questionable. Previous studies are limited to case reports and small case series and a large database may help determine the true risk of pancreatic surgery in this population. Methods. The American College of Surgeons National Surgical Quality Improvement Program database was queried (2005-2011) for patients who underwent pancreatic resection. Renal failure was defined as the clinical condition associated with rapid, steadily increasing azotemia (rise in BUN) and increasing creatinine above 3 mg/dL. Operative trends and short-term outcomes were reviewed for those with and without renal failure (RF). Results. In 18,533 patients, 28 had RF. There was no difference in wound infections, neurologic or cardiovascular complications. Compared to non-RF patients, those with RF had more unplanned intubation (OR 4.89, 95% CI 1.85-12.89), bleeding requiring transfusion (OR 3.12, 95% CI 1.37-14.21), septic shock (OR 8.86, 95% CI 3.75-20.91), higher 30-day mortality (21.4% versus 2.3%, P < 0.001) and longer hospital stay (23 versus 12 days, P < 0.001). Conclusions. RF patients have much higher morbidity and mortality after pancreatic resections and surgeons should consider this before proceeding.

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