Two open whipples a day: Excessive or efficient - 18/03/20
Abstract |
Background |
Demand for pancreatic surgery is rising, occasionally necessitating consecutive PDs to be performed by a single surgeon in the same workday. The safety of this practice is unknown.
Methods |
Institutional prospective ACS-NSQIP data were reviewed for PDs (2013–2017). Instances where a single surgeon performed two PDs in the same day were a PD pair (PD1, PD2) and compared with univariable analysis. Paired vs. unpaired-PD matched analyses were performed.
Results |
661 PDs (25-PD pairs) were performed. PD1 and PD2 revealed similar infectious (12% vs16%), pulmonary (8% vs8%), cardiovascular (12% vs4%), and aggregate (24% vs24%) morbidity (P>0.05). Pancreatic fistula (B + C 0%), delayed gastric emptying (4% vs12%), hospital stay (9.3 vs8.8 days), and 30-day mortality (4% vs4%) were similar (P > 0.05). Matched outcomes were similar except higher cardiovascular morbidity for paired vs. unpaired PD (7% vs0%; P = 0.015).
Conclusion |
With proper patient selection, and in experienced hands at high-volume centers, two consecutive open PDs may be safely performed.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Surgeons may be faced with performing two consecutive open PDs in a single workday. |
• | Our preliminary data suggest this practice may be safe under certain circumstances. |
• | Surgeon fatigue and wellbeing should be considered under such rigorous demands. |
Keywords : Pancreatoduodenectomy, Surgical outcomes, Safety
Abbreviations : ACS-NSQIP, HPB, MIPD, PD
Plan
Vol 219 - N° 3
P. 390-393 - mars 2020 Retour au numéro
Article précédent
- Music, Medicine, and Mind
- Nicholas J. Zyromski
- Discussion on: Two open whipples a day: Excessive or efficient
- R.E. Simpson, M.L. Fennerty, K.F. Flick, C.L. Colgate, E.P. Ceppa, M.G. House, N.J. Zyromski, A. Nakeeb, C.M. Schmidt
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