Impact of pancreatic resection in patients with liver cirrhosis

J Med Invest. 2023;70(1.2):189-194. doi: 10.2152/jmi.70.189.

Abstract

Background: Several reports have shown a high mortality rate in patients with liver cirrhosis (LC) who undergo pancreaticoduodenectomy, however, there are few reports on its long-term prognosis.

Methods: Twelve patients with LC who had undergone pancreatic resection were enrolled. To compare clinicopathological variables, 159 non-LC patients who had undergone resection for pancreatic cancer were enrolled.

Results: Pancreaticoduodenectomy (PD) was performed in 5 LC patients and distal pancreatectomy (DP) was performed in 7 LC patients. Patients in the LC group had more co-morbidities, lower platelet counts and higher Fib4 index than the non-LC group. The postoperative complication rate was higher in the LC group (83.3% vs 47.8%). While the postoperative hospital stay and 30-day mortality rate were not different, the 90-day mortality rate was higher in the LC group (25.0% vs 2.5% ; p<0.01). Comparison by operative procedure showed no significant differences of postoperative outcomes in DP cases. However, in PD cases, postoperative complications were more frequent (100% vs 42.3%) and 90-day mortality was higher (40.0% vs 2.9% ; p<0.01) in the LC group.

Conclusions: PD resulted in higher postoperative morbidity and mortality rates in patients with LC compared with non-LC patients. DP could be tolerated in the LC patients. J. Med. Invest. 70 : 189-194, February, 2023.

Keywords: liver cirrhosis; pancreas; pancreatectomy; pancreaticoduodenectomy; surgery.

MeSH terms

  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / surgery
  • Pancreatectomy* / adverse effects
  • Pancreatectomy* / methods
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Treatment Outcome