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Preoperative chemoradiotherapy but not chemotherapy is associated with reduced risk of postoperative pancreatic fistula after pancreatoduodenectomy for pancreatic ductal adenocarcinoma: a nationwide analysis

Leonoor Wismans,J. Annelie Suurmeijer,Jelle C. van Dongen,Bert A. Bonsing,Hjalmar C. Van Santvoort,Johanna W. Wilmink,Geertjan van Tienhoven,Ignace H. de Hingh,Daan J. Lips,Erwin van der Harst,Vincent E. de Meijer,Gijs A. Patijn,Koop Bosscha,Martijn W. Stommel,Sebastiaan Festen,Marcel den Dulk,Joost J. Nuyttens,Martijn P. W. Intven,Judith de Vos-Geelen,I. Quintus Molenaar, Olivier R. Busch, Bas Groot Koerkamp, Marc G. Besselink,Casper H. J. van Eijck

SURGERY（2024）

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Abstract
Background: Postoperative pancreatic fistula remains the leading cause of significant morbidity after pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Preoperative chemoradiotherapy has been described to reduce the risk of postoperative pancreatic fistula, but randomized trials on neoadjuvant treatment in pancreatic ductal adenocarcinoma focus increasingly on preoperative chemotherapy rather than preoperative chemoradiotherapy. This study aimed to investigate the impact of preoperative chemotherapy and preoperative chemoradiotherapy on postoperative pancreatic fistula and other pancreatic-specific surgery related complications on a nationwide level.
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