Cannabis use and post-operative complications in patients undergoing pancreatic resection. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Madsen, Helen J.; Carmichael, Heather; Reinicke, Trenton; Gleisner, Ana L.; Del Chiaro, Marco; Schulick, Richard D.; Stewart, Camille L.
• Is Part Of: HPB. Volume 25:Issue 4(2023)
• Page Start: 431
• Page End: 438
• Publication Date: 2023-04
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2023.01.006
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Many states have legalized medical cannabis with various reported therapeutic benefits. However, there is little data assessing the effects of cannabis on surgical outcomes. We sought to compare post-operative pancreatic resection complications between cannabis users and non-users. Methods: This is a single-center, retrospective review of patients who underwent Whipple or distal pancreatectomy from 1/2017-12/2020. The primary outcome was any in-hospital complication, using Clavien-Dindo. Multivariable regression analysis was performed. Results: There were 486 patients who underwent Whipple (n=346, 71.2%) or distal pancreatectomy (n=140, 28.8%). Overall, 21.4% (n=104) reported cannabis use, of whom 80.8% were current users. Cannabis users were younger (60 vs. 66 years, p < 0.001), and more likely to have smoked tobacco (p=0.04), but otherwise had similar demographics as non-users. There were 288 (59.3%) patients who developed an in-hospital complication (grade 1–2, 75.3%; grade 3–5, 24.7%). A trend towards increased complications was observed with tobacco smoking (OR 1.33, 95% CI 0.91–1.94, p=0.14), but no association of cannabis use with complications was observed (OR 0.93, 95% CI 0.58–1.47, p=0.74). Discussion: A significant proportion of patients undergoing pancreatic resection report cannabis use. These results suggest that there was no association between cannabis use and post-operative complications, future prospective evaluation is warranted. Graphical abstract: Image 1