Factors Influencing Readmission After Pancreaticoduodenectomy

Ahmad, Syed A.; Edwards, Michael J.; Sutton, Jeffrey M.; Grewal, Sanjeet S.; Hanseman, Dennis J.; Maithel, Shishir K.; Patel, Sameer H.; Bentram, David; Weber, Sharon M.; Cho, Clifford S.; Winslow, Emily R.; Scoggins, Charles R.; Martin, Robert C.G.; Kim, Hee Jin; Baker, Justin; Merchant, Nipun B.; Parikh, Alexander A.; Kooby, David A.

doi:10.1097/sla.0b013e318265ef0b

Cited by 258 publications

(196 citation statements)

References 15 publications

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“…Complete embolization of the arteries around the duodenum may also be ineffective and was furthermore anticipated to induce necrosis of the adjacent organs in this case. Emergency pancreaticoduodenectomy is not a common procedure due to the associated rates of morbidity and mortality (16)(17)(18)(19); however, recent advances in surgical techniques and improvements in perisurgical management have made it relatively safe, especially when performed by experienced surgeons in training centers.…”

Section: Discussionmentioning

confidence: 99%

Primary Liposarcoma of the Duodenum: A First Case Presentation

Okabayashi¹,

Shima²,

Iwata³

et al. 2013

Intern. Med.

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A 55-year-old man suffering from melena was admitted to our hospital. A blood test showed severe anemia. Contrast-enhanced computed tomography (CT) revealed a huge lesion in the duodenum and dilatation of the common bile duct. Upper gastrointestinal endoscopy also identified hemorrhaging from the tumor in the duodenum. Due to the low density of the tumor mass, we performed emergency pylorus-preserving pancreaticoduodenectomy. Histology revealed an area of well-differentiated liposarcoma as well as an area of highgrade spindle cells and pleomorphic sarcoma without obvious differentiation. The final pathological diagnosis was dedifferentiated liposarcoma. This is the first case report of primary liposarcoma of the duodenum.

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Section: Discussionmentioning

confidence: 99%

Primary Liposarcoma of the Duodenum: A First Case Presentation

Okabayashi¹,

Shima²,

Iwata³

et al. 2013

Intern. Med.

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“…Patient demographics in terms of age, gender and BMI have not been found to affect readmission rates in most of the previous studies. [6][7][8][9][10][11][12][13][14][15][16][17] Among various biochemical parameters, hypoproteinemia was found to be a significant risk factor for readmission in the present study. Though this parameter has not been considered in majority of the studies, some authors have found it to be significant.…”

Section: Discussionmentioning

confidence: 71%

“…This is comparable to most of the procedure specific studies in the past. 3,6,8,9,13 It is likely to be due to decreased immunity leading to increased risk of infections following blood transfusion. Stoma creation has consistently been found to be a risk factor for readmission.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

et al. 2017

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Background: Unforeseen re-admissions are a consequence of natural course of patient’s disease or results from sub-optimal care during first admission. Apart from causing increased expenditure, readmission immensely adds to the distress of the patient as well as his relatives. The aim of the study was to assess the incidence and risk factors for 30-day unplanned readmission following emergency laparotomy for perforation peritonitis.Methods: This prospective observational study was conducted on 145 patients undergoing laparotomy for perforation peritonitis in over a period of two years. Various pre-operative, intra-operative and post-operative parameters were studied to identify the risk factors for readmission.Results: Overall readmission rate was 8.96% and in majority of the cases it was due to post-surgical complications. Various factors found significant for readmission were American Society of Anaesthesiology (ASA) grade (p = 0.014) hypoproteinemia (p<0.001), diabetes mellitus (p = 0.001), immuno compromised status (p<0.001), stoma creation (p<0.001), blood transfusion (p = 0.022), renal complications and UTI (p = 0.027 each). On multivariate analysis, hypoproteinemia and stoma creation were found to be significant.Conclusions: Risk factors for readmission among surgical patients are multi-factorial. Taking appropriate steps can reduce the burden of readmission. Moreover decreasing the rate of surgical readmission represents an opportunity to improve patient care.

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“…Notably, in our study the postoperative complications and readmission rate were similar. Ahmad et al [49] found that postoperative complications and higher transfusion requirements, or the presence of chronic pancreatitis, had a significant impact on 30-and 90-day readmission rates.…”

Section: Discussionmentioning

confidence: 99%

Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

Basso¹,

Maffeis²,

Lumachi³

et al. 2017

MIS

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Aim: Laparoscopic pancreatic surgery is a minimally invasive technique that has been widely applied only in the past decade. The purpose of this study was to evaluate its safety and assess whether laparoscopic distal pancreatectomy (LDP) is cost-effective compared with open distal pancreatectomy (ODP). Methods: The medical records of patients treated for leftsided pancreatic lesions were retrospectively analysed, and the analysis of costs for hospital stay, operative time, and equipment were analysed. Twelve patients underwent LDP, while 12 patients underwent ODP. Results: The two groups were homogeneous according to age, ASA score, BMI, and distribution of pathological findings. Both the size of the specimen (5.33 ± 3.2 vs. 5.58 ± 2.57 cm) and the number of removed lymph nodes (10.5 ± 4.3 vs. 12.1 ± 3.1) did not differ. Although LDP required a longer operative time (197.5 ± 33.7 vs. 122.5 ± 35.4 min), intraoperative bleeding, postoperative pain intensity (measured by VAS scale) and hospital stay were significantly reduced. Conclusion: The mini-invasive approach offers several advantages compared with open surgery, including a significant reduction of blood loss and postoperative pain, and an earlier recovery. The global costs of laparoscopic surgery should be carefully re-evaluated, considering the saving that arises from these advantages. Key words:Mini-invasive, distal pancreatectomy, laparoscopy, cost ABSTRACTArticle history:

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Factors Influencing Readmission After Pancreaticoduodenectomy

Cited by 258 publications

References 15 publications

Primary Liposarcoma of the Duodenum: A First Case Presentation

Primary Liposarcoma of the Duodenum: A First Case Presentation

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

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