A prospective cost analysis of pancreatoduodenectomy

Holbrook, Ryan F.; Margrave, Kent; Traverse, L. William

doi:10.1016/s0002-9610(96)00016-5

Cited by 45 publications

(33 citation statements)

References 5 publications

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“…for surgery (11,12) or chemotherapy (13,14), and these estimates are not directly comparable with our study. One study conducted in the US estimated the total healthcare cost for pancreatic cancer in the US to $881 million.…”

Section: Discussioncontrasting

confidence: 95%

The Cost of Treating Pancreatic Cancer

et al. 2003

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Section: Discussioncontrasting

confidence: 95%

The Cost of Treating Pancreatic Cancer

et al. 2003

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“…The median hospital charge for resection for all patients was US$ 37,317, and for those without complica-Andrén-Sandberg/Neoptolemos In this study it was also noted that surgeons performing 1-3 resections per year had significantly more complications than those performing 4 or more resections per year [49]. In a study of pancreatoduodenectomy [48] using micro-costs (operating theatre, recovery areas and hospital ward costs, with professional fees excluded) the average total cost was US$ 17,252, of which hospital ward costs comprised 79% of the total. Patients without complications had significant lower average total hospital costs (US$ 13,947) compared to patients with complications (US$ 21,574) and with a hospital stay of 7 days more.…”

Section: Economic Implicationssupporting

confidence: 52%

“…No other major elective intra-abdominal procedure is associated with such a high morbidity and mortality. It should then also be taken into account that the post-operative complications of pancreatoduodenectomy are alarmingly costly [37,48,49].…”

Section: Introductionmentioning

confidence: 99%

Resection for pancreatic cancer in the new millennium

Andrén‐Sandberg

Neoptolemos

2002

Pancreatology

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“…3,5 Average hospital costs were $21,878 for DPPHR and $25,746 for PPPD. These hospital costs were slightly more than the average total hospital costs of $17,252 reported in the 1995 study of pancreaticoduodenectomy by Holbrook et al 19 These cost differences can be attributed to variable accounting practice between the two facilities as well as the indexing of all of our cost data to 1996 dollars based on the medical care consumer price index. The $3,914 savings for DPPHR over PPPD in our study was the result of a reduction in both hospital and physician costs.…”

Section: Medical Costs In Chronic Pancreatitismentioning

confidence: 51%

“…Although not specifically analyzed in this study, postoperative complications did prolong the postoperative stay and contributed to an increase in overall hospital costs, as has been pointed out previously. 19 Although statistically significant in this small cohort of patients, these cost savings were relatively small and may not hold up over analysis of a larger group of patients.…”

Section: Medical Costs In Chronic Pancreatitismentioning

confidence: 72%

Impact of Pancreatic Head Resection on Direct Medical Costs in Patients With Chronic Pancreatitis

Howard¹,

Jones²,

Sherman³

et al. 2001

Annals of Surgery

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ObjectiveTo quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD). Summary Background DataPancreatic head resection in selected patients with chronic pancreatitis provides pain relief and improves quality of life, but the effect on healthcare costs is unknown. MethodsThis observational cohort study comprised 34 selected patients with chronic pancreatitis followed up exclusively at the authors' institution treated by either DPPHR or PPPD between 1992 and 1997. ResultsTwenty-one patients had DPPHR and 13 had PPPD. Patients in the PPPD group were slightly older, but other clinical characteristics were similar. Before surgery, the mean number of admissions per patient per year, days in the hospital per patient per year, and disease-specific hospital-based medical costs per patient per year were not significantly different between groups. After surgery, those three variables were similar between the groups but significantly less than preoperative values. Pain control remained significantly improved after 36 months of follow-up. ConclusionsIn selected patients with chronic pancreatitis, DPPHR and PPPD are equally effective in providing long-term pain relief and decreasing disease-specific hospital-based costs.Patients with chronic pancreatitis who have severe recurrent abdominal pain as the predominant symptom often require in-hospital treatment, including intravenous narcotic analgesics, gut rest, total parenteral nutrition, celiac plexus blocks, endoscopic stent therapy, pancreatic lithotripsy, and occasionally surgical resection or drainage.1 All of these interventions are associated with hospital-based medical costs. Pancreatic head resection, either pylorus-preserving pancreaticoduodenectomy (PPPD) or duodenal-preserving pancreatic head resection (DPPHR), are the operations of choice to achieve pain relief and improve quality of life in the selected group of patients with chronic pancreatitis who have a nondilated pancreatic duct (Ͻ6 mm) and an enlarged pancreatic head.2 Recent studies evaluating the safety and efficacy of surgery in patients with chronic pancreatitis have focused on perioperative complication and death rates, [3][4][5][6][7] maintenance of pancreatic function, 3,4,6,8,9 and patient outcome as assessed by either pain scores [3][4][5][6] or quality of life indices. 3,4,6 Although DPPHR and PPPD have been shown to be equivalent operations in terms of safety and efficacy, 3,5 their effect on healthcare costs is unknown. The primary aim this study was to assess the impact of surgery on the disease-specific hospital-based medical costs incurred by a selected group of patients with chronic pancreatitis undergoing pancreatic head resection. METHODSFrom 1992 until 1997, 74 consecutive patients with chronic small duct pancreatitis and an inflammatory mass (Ͼ30 mm in diameter) in the head of the pancreas who were

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A prospective cost analysis of pancreatoduodenectomy

Cited by 45 publications

References 5 publications

The Cost of Treating Pancreatic Cancer

The Cost of Treating Pancreatic Cancer

Resection for pancreatic cancer in the new millennium

Impact of Pancreatic Head Resection on Direct Medical Costs in Patients With Chronic Pancreatitis

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