Clinical Science Is prior cholecystectomy associated with decreased survival in patients with resectable pancreatic adenocarcinoma following pancreaticoduodenectomy? Suzanne C. Schiffman, M.D. a , Carrie K. Chu, M.D. b , Jaemin Park, B.S. b , Maria Russell, M.D. b , Steven Keilin, M.D. b , David A. Kooby, M.D. b , Charles R. Scoggins, M.D., M.B.Ch.B. a , Kelly M. McMasters, M.D., Ph.D. a , Robert C.G. Martin, M.D., Ph.D. a, * a Division of Surgical Oncology, Department of Surgery, University of Louisville, and the James Graham Brown Cancer Center, Louisville, KY; b Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, and the Winship Cancer Institute, Atlanta, GA, USA Abstract BACKGROUND: Patients with pancreatic cancer who present with biliary symptoms may undergo cholecystectomy and thus delay cancer diagnosis. We hypothesized that prior cholecystectomy leads to decreased overall survival in patients with pancreatic adenocarcinoma. METHODS: Retrospective study of hepatobiliary database. RESULTS: Three hundred sixty-five patients with a diagnosis of resectable periampullary pancreatic adenocarcinoma were identified. Eighty-seven patients underwent prior cholecystectomy. Median age (P = .48), body mass index (BMI) (P = .8), diabetes status (P = .06), American Society of Anesthesiologists (ASA) class (P = .22), stent placement (P = .13), operative time (P = .76), estimated blood loss (EBL) (P = .24), intraoperative transfusion (P = .91), portal vein resection (P = .25), LOS (P = .09) adjuvant therapy (P = .2), tumor size (P = .89), differentiation (P = .67), angiolymphatic invasion (P = .69), perineural invasion (P = 54), nodal metastasis (P = .43), complication rate (P = .75), and 30-day mortality (P = .58) were not statistically different between patients with previous cholecystectomy and those without. Median survival was 14 months for patients with a history of cholecystectomy and 16 months for those without (P = .25). Previous cholecystectomy was not a predictor of survival on Cox regression analysis. CONCLUSION: There was no difference in overall survival in patients with pancreatic cancer with prior cholecystectomy versus those without. © 2011 Elsevier Inc. All rights reserved. KEYWORDS: Pancreatic adenocarcinoma; Cholecystectomoy; Pancreaticoduedenectomy; Periampullary cancer Pancreatic cancer has a poor prognosis with an overall 5-year survival rate of less than 5%. 1,2 This is largely attributed to nonspecific presenting symptoms and advanced disease at diagnosis. Lack of effective adjuvant therapy and systemic chemotherapy also contribute to the low survival rate. Recent studies failed to show any significant survival benefit with neoadjuvant therapy. 3 * Corresponding author. Division of Surgical Oncology, Division of Surgical Oncology, University of Louisville, Norton, Healthcare Pavilion, 315 E. Broadway, Suite 303, Louisville, KY 40202. Tel.: +1-502- 6293355; fax: +1-502-629-3393. E-mail address: Rcmart03@louisville.edu Manuscript received December 18, 2009, accepted February 4, 2010 0002-9610/$ - see front matter © 2011 Elsevier Inc. All rights reserved. doi:10.1016/j.amjsurg.2010.02.004 The American Journal of Surgery (2011) 201, 519 –524