Background: Little is known regarding the impact of the minimally invasive approach to distal pancreatectomy on the aggregate costs of care for patients undergoing distal pancreatectomy.
Methods: We queried the Healthcare Cost and Utilization Project State Inpatient Database to identify patients undergoing elective laparoscopic distal pancreatectomy or open distal pancreatectomy between 2012 and 2014. Multivariable regression was used to evaluate postoperative outcomes including readmissions to 90 days after distal pancreatectomy.
Results: A total of 267 (11%) patients underwent laparoscopic distal pancreatectomy, and a total of 2,214 (89%) underwent open distal pancreatectomy. On multivariable regression, patients undergoing laparoscopic distal pancreatectomy had a decreased odds risk of having any severe adverse outcome (odds ratio 0.73, 95% confidence interval [0.54-0.97]), prolonged length of stay (odds ratio 0.49, 95% confidence interval [0.30-0.79]), and of being in the highest quartile for aggregate costs of care (odds ratio 0.46, 95% confidence interval [0.32-0.66]) relative to those undergoing open distal pancreatectomy. Patients undergoing laparoscopic distal pancreatectomy had a lower average 90-day aggregate cost of care than those undergoing open distal pancreatectomy when procedures were performed in high-volume (-$16,153, 95% CI: [-$23,342 to -$8,964]) centers.
Conclusion: Patients undergoing laparoscopic distal pancreatectomy have a lower risk of severe adverse outcomes, prolonged overall length of stay, and lower associated costs of care relative to those undergoing open distal pancreatectomy. This association is independent of hospital volume.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660990 | PMC |
| http://dx.doi.org/10.1016/j.surg.2019.04.019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Laparoscopic and Open Distal Pancreatectomy-An Initial Single-Institution Experience with a Propensity Score Matching Analysis.
Life (Basel)
January 2025
Clinical Department of Abdominal and General Surgery, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia.
Laparoscopic distal pancreatectomy is a minimally invasive approach for the surgical treatment of neoplasms in the distal pancreas. This study aimed to compare this approach to the open procedure. A retrospective analysis of a prospectively maintained database of 400 pancreatectomies was performed.
View Article and Find Full Text PDFPancreatic Fistula and Intraabdominal Fluid Collections after Distal Pancreatectomy: Incidence, Implications, and Natural History.
Ann Surg
January 2025
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Objective: To investigate the incidence and management of pancreatic fistula and fluid collections (FC) after distal pancreatectomy (DP).
Summary Background Data: Pancreatic fistula and FC are common after DP. The relationship between pancreatic fistula, FC, and surgical drain placement remains unclear.
A Novel Method for Hemorrhage Control During Laparoscopic Distal Pancreatectomy with Splenic Vessel Preservation: Triple Occlusion.
Ann Surg Oncol
January 2025
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction: Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP). Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures.
View Article and Find Full Text PDFTotal Pancreatectomy for Locally Advanced Pancreatic Adenocarcinoma with Coeliac Trunk Resection and Retrograde Gastric Revascularization Through Aorto-Hepato-Spleno Allograft.
Ann Surg Oncol
January 2025
Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris-Cité, Clichy, France.
Background: Locally advanced pancreatic adenocarcinomas (LA-PDAC) are more frequently operated now than in the past because of new regimen chemotherapy and improvement in surgical technique. Resection of the coeliac trunk (CT) during pancreatoduodenectomy (PD) or total pancreatectomy (TP) is not routinely done owing to the risk of liver and gastric ischaemia. In this video, a patient with LA-PDAC underwent TP with CT resection and retrograde gastric revascularization through the distal splenic artery.
View Article and Find Full Text PDFApplication and advantage analysis of triangular gastric suspension technique in laparoscopic distal pancreatectomy.
Surg Endosc
January 2025
Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Lihuili Hospital of Ningbo University, 57 Xingning Road, Ningbo, Zhejiang, China.
Background: Laparoscopic distal pancreatectomy is a safe and effective surgical method for treating benign and malignant tumors of the pancreatic body and tail. However, laparoscopic surgery requires good intraoperative exposure, and since the pancreas is obstructed by the stomach and duodenum, making surgical operations and the management of intraoperative emergencies challenging. Therefore, gastric traction is crucial in laparoscopic distal pancreatectomy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!