You are here

  • Home
  • Archive
  • Volume 29, Issue Suppl 4
  • EP1224 Predictors and clinical outcome of pancreatic fistula in patients receiving splenectomy for advanced or recurrent ovarian cancer: a large multicentric experience

Article Text

Article menu
Download PDFPDF
ePoster Talks: Ovarian + Endometria
EP1224 Predictors and clinical outcome of pancreatic fistula in patients receiving splenectomy for advanced or recurrent ovarian cancer: a large multicentric experience
  1. G Sozzi1,2,
  2. C Cicero1,
  3. A Fagotti3,
  4. M Petrillo4,
  5. S Domingo5,
  6. V Lago5,
  7. R Berretta6,
  8. G Paci7,
  9. V Vargiu3,
  10. G Scambia3 and
  11. V Chiantera1,2
  1. 1Department of Gynecologic Oncology, ARNAS Civico Hospital
  2. 2University of Palermo, Palermo
  3. 3Department of Women’s and Children’s Health, Catholic University of the Sacred Heart, Roma
  4. 4Department of Obstetrics and Gynecology, University of Sassari, Sassari, Italy
  5. 5Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Spain
  6. 6Department of Obstetrics and Gynecology, University of Parma, Parma
  7. 7Department of Gynecologic Oncology, University of Palermo, Palermo, Italy

Abstract

Introduction/Background The aim of the surgical treatment of advanced ovarian cancer is to completely remove all macroscopic disease.To achieve optimal cytoreduction, the use of extensive upper abdominal surgery has become widely accepted.Although the disease doesn’t usually invade the splenic parenchyma, the capsule may commonly be infiltrated. These metastases may be difficult to be dissected from the pancreatic tail and a partial pancreatic resection en bloc with spleen may be required. The objective of this study is to evaluate predictors and clinical outcome of pancreatic fistula in patients receiving splenectomy for advanced or recurrent ovarian cancer.

Methodology Data of women receiving splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancer from December 2012 to May 2018 were retrospectively retrieved from the oncological databases of five institutions. Criteria’s used to identify pancreatic leaks were measurement of lipase and amylase level on peri-pancreatic drainage fluid, imaging and abdominal pain referable to pancreatitis.Surgical and post-operative data were analyzed.

Results Overall 260 patients were included in the study.Pancreatic resection was performed in 45 (17.6%) women, among them 23 patients received only pancreatic capsule resection and 22 received distal pancreatic tail resection. Intraperitoneal hypertermic chemotherapy (HIPEC) was performed in 28 (10.8%) cases. Pancreatic fistula was detected in 32 (12.3%) cases. At multivariable analysis pancreatic resection (OR: 2.064; p: 0.040), in particular pancreatic tail resection (OR:3.055; p: 0.003) and HIPEC administration (OR: 1.910; p: 0.057) were identified as independent predictors of pancreatic fistula.

Conclusion Twelve percent of patients who received splenectomy during cytoreductive surgery for ovarian cancer developed a pancreatic leak.Distal pancreatectomy and HIPEC administration have been identified as independent predictors of pancreatic fistula in this subset of patients. No significant delay in initiation of adjuvant chemotherapy was observed in women with leakage.

Disclosure Nothing to disclose.

Abstract EP1224 Figure 1
Abstract EP1224 Figure 1

Differences in term of time to chemotherapy according to pancreatic resection (A) or HIPEC (B)

Abstract EP1224 Figure 2
Abstract EP1224 Figure 2

Spleen resected en bloc with omentum, parietal and diaphragmatic peritoneum, uterus and rectum

View this table:
Abstract EP1224 Table 1

Univariate and multivariate analysis of predictors of pancreatic fistula in the overall study population

https://doi.org/10.1136/ijgc-2019-ESGO.58

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.