Pancreatic resections, including pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy, remain the only potentially curative interventions for pancreatic cancer.
Dr James McPhee and colleagues analyzed in-hospital mortality after pancreatectomy using a large national database.
The investigative team defined factors affecting outcomes after pancreatectomy for neoplasm.
|In-hospital mortality decreased to 5% in 2003|
|Annals of Surgery|
The team performed a retrospective analysis using all patients undergoing pancreatic resections for neoplastic disease.
The investigators identified the patients from the Nationwide Inpatient Sample from 1998 to 2003.
Crude in-hospital mortality was analyzed by [chi]2, and the team constructed a multivariable model.
The research team adjusted for age, sex, hospital teaching status, hospital surgical volume, year of resection, payer status, and selected comorbid conditions.
The investigators identified 279,445 patient discharges with a primary diagnosis of pancreatic neoplasm.
A total of 14% patients underwent resection during that hospitalization.
In-hospital mortality was 6% with a significant decrease from 8% to 5% from 1998 to 2003 by trend analysis.
The team undertook resections at low- and medium-volume centers had higher mortality compared with those at high-volume centers.
The investigators found the proportion of procedures performed at high volume centers increased from 30% to 39% over the 6-year time period by trend test.
Dr McPhee‘s team concluded, "This large observational study demonstrates an improvement in operative mortality for patients undergoing pancreatectomy for neoplastic disease from 1998 to 2003."
"In addition, a greater proportion of pancreatectomies were performed at high-volume centers in 2003."
"The regionalization of pancreatic surgery may have partially contributed to the observed decrease in mortality rates."