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News

Grading system defines pancreaticoduodenectomy morbidity

A prospective complication grading system helps define morbidity after pancreaticoduodenectomy, finds the latest Journal of the American College of Surgeons.

News image

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Improving surgical quality of care requires accurate reporting of postoperative complications.

Dr Stephen Grobmyer and colleagues from New York assessed accuracy of a prospective surgical complication grading database.

The research team performed a retrospective review of 204 pancreaticoduodenectomies.

The pancreaticoduodenectomies were entered into the database from 2001 to 2003.

This updated database was then used to characterize 30-day morbidity and mortality after pancreaticoduodenectomy.

47% had at least 1 postoperative complication
Journal of the American College of Surgeons

The researchers found on review that 13% of patients had a complication not identified in the prospective complication database.

The team reclassified complications in 8% of patients, and 4% of patients had a complication removed.

At least 1 postoperative complication was experienced by 47% of patients.

After pancreaticoduodenectomy, the team observed that 45 different complications occurred.

The researchers noted that postoperative mortality at 30 days was 1%, and 30-day readmission rate was 11%.

The team found that the 30-day reoperation rate was 9%.

About 14% of patients required a percutaneous drainage procedure.

Pancreatic anastomotic leak occurred in 12%, wound infection in 11%, and delayed gastric emptying in 7%.

The research team observed that these were the 3 most common postoperative complications.

In addition, the team noted that all 3 complications were associated with an increased length of stay.

Dr Grobmyer's team concluded, “Prospective surgical complication database accurately characterized outcomes after pancreaticoduodenectomie and facilitated information gathering and analysis.”

“The accuracy, efficiency, and reproducibility of a prospective surgical complication database favor its widespread use in postoperative complication reporting.”

J Am Coll Surg 2007: 204(3): 356-64
14 March 2007

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