title: Is prior cholecystectomy associated with decreased survival in patients with resectable pancreatic adenocarcinoma following pancreaticoduodenectomy?
abstract: BACKGROUND
  Patients with pancreatic cancer who present with biliary symptoms may undergo cholecystectomy and thus delay cancer diagnosis. We hypothesized that prior cholecystectomy leads to decreased overall survival in patients with pancreatic adenocarcinoma.
  
  
  METHODS
  Retrospective study of hepatobiliary database.
  
  
  RESULTS
  Three hundred sixty-five patients with a diagnosis of resectable periampullary pancreatic adenocarcinoma were identified. Eighty-seven patients underwent prior cholecystectomy. Median age (P = .48), body mass index (BMI) (P = .8), diabetes status (P = .06), American Society of Anesthesiologists (ASA) class (P = .22), stent placement (P = .13), operative time (P = .76), estimated blood loss (EBL) (P = .24), intraoperative transfusion (P = .91), portal vein resection (P = .25), LOS (P = .09) adjuvant therapy (P = .2), tumor size (P = .89), differentiation (P = .67), angiolymphatic invasion (P = .69), perineural invasion (P = 54), nodal metastasis (P = .43), complication rate (P = .75), and 30-day mortality (P = .58) were not statistically different between patients with previous cholecystectomy and those without. Median survival was 14 months for patients with a history of cholecystectomy and 16 months for those without (P = .25). Previous cholecystectomy was not a predictor of survival on Cox regression analysis.
  
  
  CONCLUSIONS
  There was no difference in overall survival in patients with pancreatic cancer with prior cholecystectomy versus those without.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Louisville, James Graham Brown Cancer Center, KY, USA.
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Schiffman
authors.forename: Carrie K
authors.initials: CK
authors.lastname: Chu
authors.forename: Jaemin
authors.initials: J
authors.lastname: Park
authors.forename: Maria
authors.initials: M
authors.lastname: Russell
authors.forename: Steven
authors.initials: S
authors.lastname: Keilin
authors.forename: David A
authors.initials: DA
authors.lastname: Kooby
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome