胰腺癌残留物的全胰腺切除术(TP)的安全性与可行性尚存在争议，且很少与初次TP相比较。因此，我们旨在比较这两种方法在引起胰腺状态方面的安全性。本研究包括2006年至2018年间接受TP治疗的胰腺肿瘤患者。肿瘤病理学分为三个亚组，根据存活曲线进行分类。我们使用1:1倾向性分数匹配（PSM）进行年龄、性别、Charlson共病指数和肿瘤分期分析。最后，我们分析了Clavien-Dindo分类（CDC）级别、其他相关安全性风险和侵袭性癌症患者的生存率等主要结果。 在54名患者中，16名接受完整TP（29.6％），而38名（70.4％）接受初次TP。在PSM分析之前，完成TP组的年龄和Charlson共病指数显着较高，T分期和肿瘤分期显着较低。在PSM分析中，这两个组在CDC级别、其他安全性结果方面是相当的。此外，尽管侵袭性癌症患者的总体生存率和无复发生存率在这两组之间没有显着差异，但初次TP组的T分期和肿瘤分期趋于严重。 PSM分析预后因素表明，完整TP和初次TP具有类似的安全性结局，可作为胰腺肿瘤手术决策的参考依据。 ©2023年。外科肿瘤学会。

The safety and feasibility of completion total pancreatectomy (TP) for remnant pancreatic neoplasms remain controversial and are rarely compared with that of initial TP. Thus, we aimed to compare the safety of these two procedures inducing a pancreatic state.Patients who underwent TP for pancreatic neoplasms between 2006 and 2018 at our institution were included in this study. Tumor pathologies were classified into three subgroups according to survival curves. We used 1:1 propensity score matching (PSM) to analyze age, sex, Charlson Comorbidity Index, and tumor stage. Finally, we analyzed the primary outcome Clavien-Dindo classification (CDC) grade, risks of other safety-related outcomes, and the survival rate of patients with invasive cancer.Of 54 patients, 16 underwent completion TP (29.6%) and 38 (70.4%) underwent initial TP. Before PSM analysis, age and Charlson Comorbidity Index were significantly higher, and T category and stage were significantly lower for the completion TP group. Upon PSM analysis, these two groups were equivalent in CDC grade [initial TP vs. completion TP: 71.4% (10/14) vs. 78.6% (11/14); p = 0.678] and other safety-related outcomes. Additionally, while the overall survival and recurrence-free survival of patients with invasive cancer were not significantly different between these two groups, the T category and stage tended to be remarkably severe in the initial TP group.PSM analysis for prognostic factors showed that completion TP and initial TP have similar safety-related outcomes that can be used as a decision-making reference in the surgery of pancreatic tumors.© 2023. Society of Surgical Oncology.