# Diarrhea after pancreatic surgery is associated with the extent of resection: a single-center retrospective cohort-study

## TL;DR

This study finds that extended pancreatic surgeries, especially those involving vascular resections, are strongly linked to postoperative diarrhea, which prolongs hospital stays.

## Contribution

The study identifies the extent of pancreatic resection and vascular involvement as key risk factors for postoperative diarrhea.

## Key findings

- 71 out of 320 patients (22.2%) developed postoperative diarrhea.
- Arterial divestment and venous resection were strongly associated with increased risk of diarrhea.
- Diarrhea led to a significantly longer hospital stay (19 vs. 13 days).

## Abstract

Diarrhea after pancreatic surgery is gaining growing importance since extended pancreatic resections have been increasingly performed. The aim of this study was to determine the incidence of diarrhea after pancreatic surgery with a special focus on the extent of resection and subgroups at higher risk for diarrhea.

Retrospectively collected data of all consecutive patients undergoing pancreatic surgery between 01/2021 and 11/2023 were analyzed. Information on bowel movements was prospectively documented. Diarrhea was defined as > 3 bowel movements per day for at least 72 h despite pancreatic enzyme replacement and in the absence of laxatives or prokinetics. Extended resections were differentiated according to the type of vascular resection and arterial divestment. Clinicopathological characteristics and outcomes were compared among these groups and risk factors for diarrhea were identified.

A total of 320 patients were included. Following any type of pancreatectomy, 71/320 (22.2%) patients developed diarrhea. The incidence of diarrhea after partial pancreatoduodenectomy, distal pancreatectomy and total pancreatectomy was 26.6%, 11.5% and 35.3%, respectively (p = 0.004). Arterial divestment/resection and venous resection were significantly associated with an increased risk for postoperative diarrhea in 87% (OR = 31.14; 95%-CI: 8.77, 170.08; p < 0.001) and 52.2% of patients (OR = 5.14; 95%-CI: 2.51, 10.52; p < 0.001), respectively. Postoperative diarrhea was significantly associated with a prolonged length of hospital stay (19 vs. 13 days; 95%-CI: 3.00, 7.00; p < 0.001).

Diarrhea after pancreatic resection is a common postoperative complication affecting especially patients undergoing extended resections with vascular resections and arterial divestment. Diarrhea significantly impairs postoperative recovery leading to a prolonged hospital stay.