Impact of prior cholecystectomy on perioperative outcomes after resection for pancreatic cancer: a single-center, retrospective cohort study in a Chinese population

Abstract

Background: Cholecystectomy is carried out as one of the most extensive abdominal surgery. Patients with a long-term history of cholecystectomy may have an increased risk of pancreatic cancer. However, it’s uncertain whether prior cholecystectomy is associated with the outcome of patients with pancreatic cancer. This study was to demonstrate that prior cholecystectomy may lead to adverse perioperative outcomes in patients with pancreatic adenocarcinoma. Methods: Retrospective study comprising 755 consecutive patients with pathological diagnosis of pancreatic adenocarcinoma in Pancreas Center of the First Affiliated Hospital of Nanjing Medical University (January 2010 to December 2015) was conducted. Demographic details, surgery, tumor stage, pathology and complications were assessed. Patients were divided into NPC (no prior cholecystectomy) group and PC (prior cholecystectomy) group. PC group consist of three subgroups: RC (recent cholecystectomy), LTC (long term cholecystectomy), MTC (medium term cholecystectomy) group. Results: A total of 9.3% (70/755) of the patients underwent prior cholecystectomy, which was significantly more frequent than other operations. The rate is also abnormally higher than Chinese population (1.2%, 31/2,579). Five hundred and fifty-three patients with radical resection were selected. Compared to NPC group, PC group has more progressive tumor with relatively higher level of serum CA19-9 and possibly higher rate of lymph node metastasis. Further analysis showed that RC group had remarkably longer surgery time and more blood loss than NPC group. There was no significant difference of operative time and blood loss between LTC/MTC group and NPC group. Postoperatively, there was no statistical difference between LTC/MTC group and NPC group in complications as POPF (postoperative pancreatic fistula), DGE (delayed gastric emptying), hemorrhage and infection. There was also no notably difference in length of hospital stay these two groups. Conclusions: There is an abnormally high proportion of patients with cholecystectomy history in Chinese patients with pancreatic cancer. Patients with recent cholecystectomy history may have adverse perioperative outcome.