Is prior cholecystectomy associated with decreased survival in patients with resectable pancreatic adenocarcinoma following pancreaticoduodenectomy?
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.
Schiffman
Suzanne C
SC
Division of Surgical Oncology, Department of Surgery, University of Louisville, James Graham Brown Cancer Center, KY, USA.
Chu
Carrie K
CK
Park
Jaemin
J
Russell
Maria
M
Keilin
Steven
S
Kooby
David A
DA
Scoggins
Charles R
CR
McMasters
Kelly M
KM
Martin
Robert C G
RC
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