Evidence map›Paper›PMID 42263216›Full record

ArticleBJS open2026

Neurogenic diarrhoea after superior mesenteric artery divestment or resection for pancreatic adenocarcinoma following preoperative chemotherapy: international multicentre retrospective study.

Thomas F Stoop, Chiara Croce, Hiroyuki Ishida, Mahsoem Ali, Ammar A Javed, Asif Halimi, Atsushi Oba, Bas Groot Koerkamp, Carl-Stephan Leonhardt, Cornelius A Thiels and 31 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BJS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

  1. Observational
4 · The record

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5 · Who and what money

Authors and funding

41 authors.

Thomas F StoopAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Chiara CroceDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Hiroyuki IshidaDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Mahsoem AliCancer Center Amsterdam, Amsterdam, the Netherlands.ORCID 0000-0002-0511-6323
Ammar A JavedDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, NewYork University Medical Center, New York City, New York, USA.
Asif HalimiDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Atsushi ObaDepartment of Hepatobiliary and Pancreatic Surgery, Institute of Science Tokyo, Tokyo, Japan.ORCID 0000-0002-7315-0830
Bas Groot KoerkampDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.ORCID 0000-0003-1917-6973
Carl-Stephan LeonhardtDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0009-0001-7179-9580
Cornelius A ThielsDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Elena RangelovaDepartment of Upper Abdominal Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Ernesto SparrelidDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Ira SotirovaDepartment of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Sweden.
Jennifer L LeitingDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Jun TauchiDepartment of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Kosuke KobayashiDepartment of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Marit KlosAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Lysanne P M BeukDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Luana GenovaDepartment of Upper Abdominal Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Manuela MastronardiDepartment of Upper Abdominal Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID 0000-0003-3525-3692
Michael L KendrickDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Nabiha A MughalDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, NewYork University Medical Center, New York City, New York, USA.
Olivier R BuschAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.ORCID 0000-0001-9605-6831
Oskar FranklinDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.ORCID 0000-0002-3777-6887
Patrik LarssonDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Ulla KlaiberDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-9287-1174
Richard D SchulickDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Rutger T TheijseAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
Oliver StrobelDivision of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
Poya GhorbaniDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Roeland F de WildeDepartment of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Salvador Rodriguez FrancoDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Toshitaka SugawaraDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.ORCID 0000-0001-7211-6094
Johanna W WilminkCancer Center Amsterdam, Amsterdam, the Netherlands.
Wells MessersmithDivision of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Marc G BesselinkAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.ORCID 0000-0003-2650-9350
Christopher L WolfgangDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, NewYork University Medical Center, New York City, New York, USA.
Yosuke InoueDepartment of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Mark J TrutyDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Marco Del ChiaroDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
International Collaboration on Advanced Pancreatic Cancer

Funding

Bengt Ihre Research Fellowship GrantBengt Ihre Research Foundation SLS-986656Cancer Center AmsterdamCancerforskningfonden i Norrland AMP 23-1127CultuurfondsDeltaplan Alvleesklierkanker NCT05524090Dutch Cancer SocietyRegion Västerbotten in Umeå, Sweden RV 967602Royal Swedish Academy of Sciences LM2021-0010Royal Swedish Academy of Sciences LM2023-0012Sjöberg FoundationSwedish Society of Medicine SLS-934237
6 · The paper itself

Abstract

backgroundThe increased use of superior mesenteric artery (SMA) divestment has been a driver behind the increased resection rate for locally advanced pancreatic cancer following preoperative therapy. This has also resulted in an increase in the rate of postoperative neurogenic diarrhoea, but knowledge about postoperative neurogenic diarrhoea is lacking. The aims of this study were to determine the incidence, risk factors, management, and outcomes of neurogenic diarrhoea after SMA divestment/resection for pancreatic adenocarcinoma.

methodsThis multicentre retrospective study included consecutive patients undergoing pancreatic adenocarcinoma resection, including SMA divestment/resection, after preoperative chemotherapy with or without radiotherapy between 2016 and 2022. Primary endpoints were the incidence of postoperative neurogenic diarrhoea, associated factors, treatment strategies, and outcomes. Secondary endpoints were the rate of adjuvant chemotherapy and the impact of neurogenic diarrhoea on overall survival (OS).

resultsOverall, 291 patients who underwent pancreatic resection with concomitant SMA divestment (240, 82%) or resection (51, 18%) were included in the study. Postoperative neurogenic diarrhoea was diagnosed in 193 patients. The adjusted risk of developing neurogenic diarrhoea was 59% (95% confidence interval (c.i.) 46 to 73) after ≤ 180° SMA divestment, 80% (95% c.i. 67 to 93) after > 180° SMA divestment, and 77% (95% c.i. 66 to 88) after SMA resection. Postoperative neurogenic diarrhoea was treated with non-opioid drugs (29, 15%), non-opium opioids (140, 73%), opium tincture (69, 36%), and/or octreotide (49, 25%), and normalized in 51% of patients. After adjusting for confounders, neurogenic diarrhoea was not significantly associated with OS (hazard ratio 0.83; 95% c.i. 0.55 to 1.25).

conclusionNeurogenic diarrhoea occurred in two-thirds of patients following resection of pancreatic adenocarcinoma with concomitant SMA divestment/resection, particularly after > 180° SMA divestment or SMA resection. Although challenging to manage, neurogenic diarrhoea is not associated with impaired OS. Evidence-based treatment strategies are needed for adequate management.

Indexed as

AdenocarcinomaDiarrheaMesenteric Artery, SuperiorPancreatectomyPancreatic NeoplasmsPostoperative ComplicationsAgedChemotherapy, AdjuvantFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk Factorsarterial divestmentarterial resectionpancreatic cancertherapeutic management

Identifiers

PMID42263216
PMCPMC13247994

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