Table 2.
Chronological comparison of clinical, operative, pathological characteristics and short-term postoperative outcomes (number (percent) and mean ± standard deviation).
| All patients (n = 142) | Early period 1995–2007 (n = 69) | Late period 2008–2015 (n = 73) | P-value | |
|---|---|---|---|---|
| [Clinicalcharacteristics] | ||||
| Age (median, years) | 61 | 58 | 64 | .016 |
| Sex | .389 | |||
| Male | 88 (62.0) | 40 (58.0) | 48 (65.8) | |
| Female | 54 (38.0) | 29 (42.0) | 25 (34.2) | |
| BMI (kg/m2) | 22.6 ± 3.0 | 22.5 ± 3.1 | 22.6 ± 2.9 | .826 |
| Comorbidities | ||||
| Cardiovascular | 51 (35.9) | 16 (23.2) | 35 (47.9) | .003 |
| Cerebrovascular | 4 (2.8) | 0 (0.0) | 4 (5.5) | .120 |
| Pulmonary | 7 (4.9) | 4 (5.8) | 3 (4.1) | .713 |
| Etc. | 11 (7.7) | 1 (1.4) | 10 (13.7) | .009 |
| Preoperative DM | .093 | |||
| No | 71 (50.0) | 40 (58.0) | 31 (42.5) | |
| Yes | 71 (50.0) | 29 (42.0) | 42 (57.5) | |
| ASA score | .544 | |||
| 1 | 23 (16.2) | 13 (18.8) | 10 (13.7) | |
| 2 | 109 (76.8) | 50 (72.5) | 59 (80.8) | |
| 3 | 10 (7.0) | 6 (8.7) | 4 (5.5) | |
| Preoperative albumin (g/dL) | 4.0 ± 0.5 | 3.9 ± 0.4 | 4.0 ± 0.5 | .074 |
| Preoperative total protein (g/dL) | 6.8 ± 0.6 | 6.9 ± 0.5 | 6.7 ± 0.6 | .015 |
| [Operative characteristics] | ||||
| Combined vascular resection | <.001 | |||
| No | 117 (82.4) | 65 (94.2) | 52 (71.2) | |
| Yes | 25 (17.6) | 4 (5.8) | 21 (28.8) | |
| Additional organ resection | 1.000 | |||
| No | 130 (91.5) | 63 (91.3) | 67 (91.8) | |
| Yes | 12 (8.5) | 6 (8.7) | 6 (8.2) | |
| Operation time (minutes) | 364.1 ± 90.6 | 373.6 ± 74.2 | 355.1 ± 103.5 | .222 |
| Estimated blood loss (mL) | 1062.6 ± 1363.9 | 1176.0 ± 1199.5 | 955.5 ± 1503.3 | .337 |
| [Pathological characteristics] | ||||
| Origin of indication | .160 | |||
| Pancreas | 131 (92.3) | 61 (88.4) | 70 (95.9) | |
| Distal bile duct | 7 (4.9) | 6 (8.7) | 1 (1.4) | |
| Ampulla of Vater | 2 (1.4) | 1 (1.4) | 1 (1.4) | |
| Duodenum | 2 (1.4) | 1 (1.4) | 1 (1.4) | |
| Pathology | .271 | |||
| Malignancy | 117 (82.4) | 54 (78.3) | 63 (86.3) | |
| Benign | 25 (17.6) | 15 (21.7) | 10 (13.7) | |
| Histology | .219 | |||
| Adenocarcinoma | 89 (62.7) | 41 (59.4) | 48 (65.8) | |
| IPMN ± invasive carcinoma | 34 (23.9) | 17 (24.6) | 17 (23.3) | |
| Neuroendocrine carcinoma | 4 (2.8) | 2 (2.9) | 2 (2.7) | |
| Pancreatitis | 7 (4.9) | 5 (7.2) | 2 (2.7) | |
| Metastatic tumors | 2 (1.4) | 0 (0.0) | 2 (2.7) | |
| SCN | 1 (0.7) | 0 (0.0) | 1 (1.4) | |
| SPN | 2 (1.4) | 2 (2.9) | 0 (0.0) | |
| Acinar cell carcinoma | 1 (0.7) | 0 (0.0) | 1 (1.4) | |
| Anaplastic carcinoma | 2 (1.4) | 2 (2.9) | 0 (0.0) | |
| Margin status | .402 | |||
| R0 | 128 (90.1) | 64 (92.8) | 64 (87.7) | |
| R1 | 14 (9.9) | 5 (7.2) | 9 (12.3) | |
| Tumor differentiation | .389 | |||
| Well | 37 (32.5) | 21 (36.8) | 16 (28.1) | |
| Moderately | 48 (42.1) | 23 (40.4) | 25 (43.9) | |
| Poorly/ undifferentiated | 29 (25.4) | 13 (22.8) | 16 (28.1) | |
| Unknown | 28 | 12 | 16 | |
| N stage | .145 | |||
| N0 | 87 (61.3) | 46 (66.7) | 41 (56.2) | |
| N1 | 39 (27.5) | 18 (26.1) | 21 (28.8) | |
| N2 | 16 (11.3) | 5 (7.2) | 11 (15.1) | |
| [Postoperative outcomes] | ||||
| All of complication | 54 (38.0) | 15 (21.7) | 39 (53.4) | <.001 |
| Major morbidity | 25 (17.6) | 1 (1.4) | 24 (32.9) | <.001 |
| Clavien-Dindo classification | .001 | |||
| No complication | 88 (62.0) | 54 (78.3) | 34 (46.6) | |
| I | 15 (10.6) | 8 (11.6) | 7 (9.6) | |
| II | 19 (13.4) | 6 (8.7) | 13 (17.8) | |
| IIIa | 14 (9.9) | 1 (1.4) | 13 (17.8) | |
| IIIb | 4 (2.8) | 0 (0.0) | 4 (5.5) | |
| IVa | 1 (0.7) | 0 (0.0) | 1 (1.4) | |
| IVb | 1 (0.7) | 0 (0.0) | 1 (1.4) | |
| V | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
| Delayed gastric emptying | ||||
| All | 7 (4.9) | 1 (1.4) | 6 (8.2) | .117 |
| Grade B/C | 5 (3.5) | 0 (0.0) | 5 (6.8) | .059 |
| Post-pancreatectomy hemorrhage | ||||
| All | 4 (2.8) | 0 (0.0) | 4 (5.5) | .120 |
| Grade B/C | 4 (2.8) | 0 (0.0) | 4 (5.5) | .120 |
| Intra-abdominal fluid collection | ||||
| All | 12 (8.5) | 3 (4.3) | 9 (12.3) | .131 |
| Major | 5 (3.5) | 1 (1.4) | 4 (5.5) | .367 |
| Wound problem | ||||
| All | 8 (5.6) | 0 (0.0) | 8 (11.0) | .007 |
| Major | 8 (5.6) | 0 (0.0) | 8 (11.0) | .007 |
| Others | ||||
| All | 23 (16.2) | 11 (15.9) | 12 (16.4) | 1.000 |
| Major | 5 (3.5) | 0 (0.0) | 5 (6.8) | .059 |
| Postoperative hospitalization (days) | 20.8 ± 10.9 | 23.6 ± 11.0 | 18.1 ± 10.2 | .002 |
| Postoperative ICU stay (days) | 2.0 ± 1.7 | 2.1 ± 1.6 | 1.8 ± 1.8 | .194 |
| In-hospital mortality | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Re-admission within 90-days | 29 (20.4) | 7 (10.1) | 22 (30.1) | .004 |
| 30-days mortality | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| 90-days mortality | 3 (2.1) | 2 (2.9) | 1 (1.4) | .612 |
ASA = American society of anesthesiologists, BMI = body mass index, DM = diabetes mellitus, ICU = intensive care unit, IPMN = intraductal papillary mucinous neoplasm, SCN = serous cystic neoplasm, SPN = solid pseudopapillary neoplasm, TP = total pancreatectomy.