Costs of complications following distal pancreatectomy: a systematic review

Bodegraven, Eduard A. van; Francken, Michiel F.G.; Verkoulen, Koen; Hilal, Mohammad Abu; Dijkgraaf, Marcel G. W.; Besselink, Marc G.

doi:10.1016/j.hpb.2023.03.007

Cited by 7 publications

(1 citation statement)

References 26 publications

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“…MIDP has been proven to reduce hospital stay by 2 days and this should compensate for the higher associated costs. A recent systematic review reported significant costs for complications associated with distal pancreatectomy and suggested that hospital stay was the main contributor to cost [16]. Cost evaluation from the LAPOP randomised controlled trial after a 1-year follow up showed laparoscopic distal pancreatectomy (LDP) to be the most cost-effective [17].…”

Section: Cost Effectiveness Of Midpmentioning

confidence: 99%

Minimally Invasive versus Open Distal Pancreatectomy in the 2020s: Recent Institutional Experience and a Narrative Review of Current Evidence

Rehman,

Patel,

Bartlett

et al. 2023

JCM

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(1) Background: Distal pancreatectomy is a standard treatment for tumours of the pancreatic body and tail. Minimally invasive techniques for all types of pancreatic tumours (benign and malignant) are being established, while concerns regarding oncological safety, cost effectiveness and learning curves are being explored with prospective studies. This paper presents our unit’s data in the context of the above concerns and provides a relevant narrative review of the current literature. (2) Methods: Data were collected retrospectively between 2014 and 2021 for all adult patients who underwent elective distal pancreatectomy in our tertiary care referral HPB Unit. Data on demographics, underlying pathology, perioperative variables and post-operative complications were collected and reported using descriptive statistics. On review of the Miami guidelines, four important but less validated areas regarding distal pancreatectomy are presented in light of the current evidence; these are recent randomised controlled trials, oncological safety, cost effectiveness and learning curves in minimally invasive distal pancreatectomy (MIDP). (3) Results: 207 patients underwent distal pancreatectomy in total from 2014–2021, with 114 and 93 patients undergoing open and minimally invasive techniques, respectively. 44 patients were operated on for PDAC in the open vs. 17 in the minimally invasive group. The operative time was 212 min for the open and 248 min for the minimally invasive group. The incidence of pancreatic fistula was higher in the minimally invasive group vs. the open group (16% vs. 4%). (4) Conclusions: Our unit’s data conform with the published literature, including three randomised control trials. These published studies will not only pave the way for establishing minimally invasive techniques for suitable patients, but also define their limitations and indications. Future studies will inform us about the oncological safety, cost effectiveness, overall survival and learning curves regarding patients undergoing minimally invasive distal pancreatectomy.

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Section: Cost Effectiveness Of Midpmentioning

confidence: 99%