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.
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.
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).
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.
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- (DRUGS UNOO, LABOR)World drug report 2020. 2021 (SET OF 6 BOOKLETS): UN
- Controlled substances Act. Sect. 2016 (812)
- Cannabis for cancer - illusion or the tip of an iceberg: a review of the evidence for the use of Cannabis and synthetic cannabinoids in oncology.Expet Opin Invest Drugs. 2019; 28: 285-296
- Potential use of cannabinoids for the treatment of pancreatic cancer.J Pancreat Cancer. 2019; 5: 1-7
- Cannabinoids for medical use: a systematic review and meta-analysis.JAMA. 2015; 313: 2456-2473
- Cannabis in cancer care.Clin Pharmacol Ther. 2015; 97: 575-586
- Medical marijuana for cancer.CA A Cancer J Clin. 2015; 65: 109-122
- The use of medical marijuana in cancer.Curr Oncol Rep. 2016; 18: 40
- Surgical considerations of marijuana use in elective procedures.Heliyon. 2018; 4e00779
- The effects of cannabis and cannabinoids on anesthesia and analgesia during the perioperative period.Schmerz. 2020; 34: 314-318
- Perioperative care of cannabis users: a comprehensive review of pharmacological and anesthetic considerations.J Clin Anesth. 2019; 57: 41-49
- Perioperative cannabis as a potential solution for reducing opioid and benzodiazepine dependence.JAMA Surg. 2020; 156: 181-190
- Benchmarks in pancreatic surgery.Ann Surg. 2019; 270: 211-218
- Tobacco smoking associated with increased anastomotic disruption following pancreaticoduodenectomy.J Surg Res. 2019; 233: 199-206
- The Clavien-Dindo classification of surgical complications: five-year experience.Ann Surg. 2009; 250: 187-196
- A language and environment for statistical computing.R foundation for Statistical Computing, Vienna, Austria2020
- Acute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteers.Curr Pharmaceut Des. 2012; 18: 4966-4979
- Cardiovascular effects of marijuana and synthetic cannabinoids: the good, the bad, and the ugly.Nat Rev Cardiol. 2018; 15: 151-166
- The cannabis dilemma: a review of its associated risks and clinical efficacy.J Addict. 2015; 2015707596
- Delta 9-Tetrahydrocannabinol regulates Th1/Th2 cytokine balance in activated human T cells.J Neuroimmunol. 2002; 133: 124-131
- Cannabis consumption used by cancer patients during immunotherapy correlates with poor clinical outcome.Cancers. 2020; 12: 2447
- Cannabis use disorder and perioperative outcomes in major elective surgeries: a retrospective cohort analysis.Anesthesiology. 2020; 132: 625-635
- Cannabis use disorder and perioperative outcomes in vascular surgery.J Vasc Surg. 2021; 73 (e3): 1376-1387
- Endocannabinoid signaling at the periphery: 50 years after THC.Trends Pharmacol Sci. 2015; 36: 277-296
- Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know.Am J Cardiol. 2014; 113: 187-190
- Cannabis abuse or dependence and post-operative outcomes after appendectomy and cholecystectomy.J Surg Res. 2020; 255: 233-239
- Cannabis abuse and peri-operative complications following treatment of intracranial aneurysms: a nationwide analysis.World Neurosurg. 2021; 158: 184-195
- Patients who have cannabis use disorder have higher rates of venous thromboemboli, readmission rates, and costs following primary total knee arthroplasty.J Arthroplasty. 2020; 35: 997-1002
- Cannabis use does not affect outcomes after total knee arthroplasty.J Arthroplasty. 2019; 34: 1667-1669
- Effects of perioperative cannabis use on bariatric surgical outcomes: a systematic review.Obes Surg. 2021; 31: 299-306
- Marijuana use does not affect the outcomes of bariatric surgery.Surg Endosc. 2021; 35: 1264-1268
- The impact of marijuana use on liver transplant recipients: a 900 patient single center experience.Clin Transplant. 2021; 35e14215
Published online: January 19, 2023
Accepted: January 16, 2023
Received: February 10, 2022
Publication stageIn Press Corrected Proof
Meeting Information: Abstract presented as an On-Demand virtual presentation at the AHPBA Annual Meeting, August 2021, Miami, FL.
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.