Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study
Purpose: To study the impact of strategies focusing attention on the safety of pancreaticoduodenectomy (PD) on postoperative outcome. Methods: Since 2012, tailored pancreaticoenterostomy, modification of stent insertion and organized drain management were applied according to risk for postoperative...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Surgery in Practice and Science |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262022000857 |
| _version_ | 1797984159891718144 |
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| author | Kwang Yeol Paik Ji Seon Oh Seung Min Lee |
| author_facet | Kwang Yeol Paik Ji Seon Oh Seung Min Lee |
| author_sort | Kwang Yeol Paik |
| collection | DOAJ |
| description | Purpose: To study the impact of strategies focusing attention on the safety of pancreaticoduodenectomy (PD) on postoperative outcome. Methods: Since 2012, tailored pancreaticoenterostomy, modification of stent insertion and organized drain management were applied according to risk for postoperative pancreatic fistula (POPF). Patients who performed PD after 2012 were enrolled into the prospective cohort, named experimental group (EG), and those who performed prior 2012 were enrolled into the historical control cohort (HG). Short term surgical outcomes were analyzed. Results: HG included 90 patients and EG included 85 patients. Overall rate of Clinically relevant (CR)-POPF was 13.7% (24/175), 18.9% in HG (17/90) and 8.2% in EG (7/85), respectively (p=0.049). Postoperative delayed gastric emptying, rate of postoperative bleeding, length of hospital stay, and mortality rate did not show any difference between groups. Postoperative complications of Clavien-Dindo 3 or higher were significantly reduced in the EG (22.2% vs 8.2%, p=0.012). Conclusions: After the application of a new surgical policy and management, CR-POPF rate and high-grade complication rate decreased by more than half. |
| first_indexed | 2024-04-11T06:58:14Z |
| format | Article |
| id | doaj.art-c918d6edb67e4fe4babb98ec5e1a07a2 |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-04-11T06:58:14Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-c918d6edb67e4fe4babb98ec5e1a07a22022-12-22T04:38:57ZengElsevierSurgery in Practice and Science2666-26202022-12-0111100144Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational studyKwang Yeol Paik0Ji Seon Oh1Seung Min Lee2Corresponding author at: Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, #10,63-ro,Yeongdengpo-gu, Seoul 07345, Korea.; Department of surgery, Yeoiudo St. Mary's Hospital, College of Medicine, The Catholic University of KoreaDepartment of surgery, Yeoiudo St. Mary's Hospital, College of Medicine, The Catholic University of KoreaDepartment of surgery, Yeoiudo St. Mary's Hospital, College of Medicine, The Catholic University of KoreaPurpose: To study the impact of strategies focusing attention on the safety of pancreaticoduodenectomy (PD) on postoperative outcome. Methods: Since 2012, tailored pancreaticoenterostomy, modification of stent insertion and organized drain management were applied according to risk for postoperative pancreatic fistula (POPF). Patients who performed PD after 2012 were enrolled into the prospective cohort, named experimental group (EG), and those who performed prior 2012 were enrolled into the historical control cohort (HG). Short term surgical outcomes were analyzed. Results: HG included 90 patients and EG included 85 patients. Overall rate of Clinically relevant (CR)-POPF was 13.7% (24/175), 18.9% in HG (17/90) and 8.2% in EG (7/85), respectively (p=0.049). Postoperative delayed gastric emptying, rate of postoperative bleeding, length of hospital stay, and mortality rate did not show any difference between groups. Postoperative complications of Clavien-Dindo 3 or higher were significantly reduced in the EG (22.2% vs 8.2%, p=0.012). Conclusions: After the application of a new surgical policy and management, CR-POPF rate and high-grade complication rate decreased by more than half.http://www.sciencedirect.com/science/article/pii/S2666262022000857 |
| spellingShingle | Kwang Yeol Paik Ji Seon Oh Seung Min Lee Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study Surgery in Practice and Science |
| title | Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study |
| title_full | Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study |
| title_fullStr | Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study |
| title_full_unstemmed | Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study |
| title_short | Integration of effort for secure pancreaticoduodenectomy improved surgical outcomes: Historical observational study |
| title_sort | integration of effort for secure pancreaticoduodenectomy improved surgical outcomes historical observational study |
| url | http://www.sciencedirect.com/science/article/pii/S2666262022000857 |
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