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November 12, 2025JAMA SurgeryOpen Access

Low-risk total pancreatectomy established reference values of ≤37% for major complications and ≤6% for 90-day mortality, showing higher postoperative mortality than pancreatoduodenectomy.

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Why the study?

Reference values for total pancreatectomy based on low-risk cohorts treated at expert centers were lacking.

What are the international reference values for surgical outcomes of total pancreatectomy in low-risk patients?

Population

994 patients undergoing primary total pancreatectomy across 25 international expert centers

Comparison

Low-risk TP vs TP with vascular resection, high-risk anastomosis TP, and low-risk pancreatoduodenectomy benchmarks

Design

Multicenter case-control study

Follow-up

3-month / 90-day

Key result

Low-risk total pancreatectomy established reference values of ≤37% for major complications and ≤6% for 90-day mortality, showing higher postoperative mortality than pancreatoduodenectomy.

Authors

PMPhilip C. MüllerUniversity Hospital of BaselCBCaroline BerchtoldUniversity of BaselCKChristoph KuemmerliUniversity Hospital of Basel

Discussion

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Member takes

Overview

Provides benchmarks for low-risk TP outcomes at expert centers; extends quality metrics but leaves generalizability to broader practice open.

Study Design

Type

Case-Control (n=994)

Multicenter

Yes

Structured PICO

What are the international reference values for surgical outcomes of total pancreatectomy in low-risk patients?

P
Population
994 patients undergoing primary total pancreatectomy across 25 international centers, including 333 low-risk patients (median age 66, 48.6% female) used to derive reference values.
E
Exposure
Total pancreatectomy (TP)
C
Comparator
TP with vascular resection, TP due to high-risk pancreatic anastomosis, and benchmark values for low-risk pancreatoduodenectomy
O
Outcome
Reference values for surgical outcomes including blood loss, major complications, 3-month postoperative mortality, and retrieved lymph nodessafety

Total pancreatectomy carries significantly higher postoperative morbidity and mortality compared with pancreatoduodenectomy, and these newly defined reference values can serve for quality control in pancreatic surgery.

Cite This Study

Müller et al. (2025) conducted a case-control in Pancreatic cancer or multifocal tumors (n=994). Total pancreatectomy vs. Pancreatoduodenectomy and high-risk total pancreatectomy was evaluated on Reference values for surgical outcomes including blood loss, major complications, 90-day mortality, and retrieved lymph nodes. Low-risk total pancreatectomy established reference values of ≤37% for major complications and ≤6% for 90-day mortality, showing higher postoperative mortality than pancreatoduodenectomy.

synapsesocial.com/papers/6a972dc98107d23be4ccd18ehttps://doi.org/10.1001/jamasurg.2025.4941
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