title: [Viability of extended distal pancreatectomy for pancreatic adenocarcinoma of the body or tail].
abstract: OBJECTIVE
  To analyze the viability of extended distal pancreatectomy and the associated prognostic factors.
  
  
  METHODS
  The data of 57 patients with pancreatic adenocarcinoma who underwent standard distal pancreatectomy(DP) or extended distal pancreatectomy(EDP) from January 2011 to December 2014 were reviewed retrospectively. Thirty-five patients were performed with DP and 22 with EDP. Operation safety and survival benefit between DP and EDP were compared by t-test or χ(2) test.Cox regression analysis was used to explore the prognostic indicators.
  
  
  RESULTS
  Compared to DP group, operation time((255±91)min vs.(208±80)min)(t=2.066, P=0.044) and ratio of blood transfusion (50.0% vs.17.1%)(χ(2)=12.836, P=0.008) were greater in EDP group, respectively.There were no significant differences in amount of intraoperative blood loss and postoperative duration of hospitalization. Delayed gastric emptying was greater in EDP(22.7% vs.2.9%)(Z=-2.251, P=0.027), while other complications had no differences. Mortality and ratio of relaparotomy also showed no differences. Median survival following DP was 13.1 months compared to 8.2 months following EDP. There was no difference in survival between DP and EDP. According to the results of multivariate analysis, tumor size(RR=1.275, P=0.03)and perioperative blood transfusions(RR=2.673, P=0.04) were independent prognostic factors.
  
  
  CONCLUSIONS
  Though patients with pancreatic adenocarcinoma who undergo EDP have a worse pathologic staging, they will gain a comparable long-term survival to the patients undergo DP. Tumor size and perioperative blood transfusions are independent prognostic factors.
authors.affiliation: Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Guo
authors.forename: C L
authors.initials: CL
authors.lastname: Tan
authors.forename: H Y
authors.initials: HY
authors.lastname: Chen
authors.forename: N W
authors.initials: NW
authors.lastname: Ke
authors.forename: A
authors.initials: A
authors.lastname: Li
authors.forename: X B
authors.initials: XB
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006801:Humans; D061646:Operative Time; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome