Hospital costs of delayed gastric emptying following pancreatoduodenectomy and the financial headroom for novel prophylactic treatment strategies

Abstract

Background: Delayed gastric emptying (DGE) is one of the most common complications following pancreatoduodenectomy (PD). In-hospital costs of DGE are unknown as well as the financial headroom for novel prophylactic treatments. This retrospective study aims to estimate the hospital costs of DGE and model the financial headroom per patient for new prophylactic treatment strategies within budget. Q8 Methods: Retrospective analysis of a single-center prospective database including patients after PD (2010-2017). In-hospital costs for clinically relevant DGE (ISGPS grade B/C) were calculated by comparing patient groups with and without DGE or other complications. The financial headroom per patient was modelled for potential reductions (0-100%) of empirical DGE baseline risks (15-30%). Results: Overall, DGE was present in 156 (26.9%) of 581 patients after PD. Costs for patients with isolated DGE (n = 90) were V10 295 higher than for patients without complications (n = 333). Costs for patients with other complications including DGE (n = 66) were V9008 higher than for patients with other complications without DGE (n = 92). The financial headroom for a novel prophylactic treatment per patient undergoing PD was V975 per 10% absolute decrease of DGE risk. Discussion: Hospital costs of DGE after PD are substantial. The financial headroom per patient for new DGE prophylactic treatments can be easily calculated via www.pancreascalculator.com.

Delayed Gastric Emptying and Gastric Remnant Function After Pancreaticoduodenectomy: A Systematic Review of Objective Assessment Modalities

“…Delayed gastric emptying is a common complication following PD and is associated with increased morbidity, prolonged hospitalization and increased costs to healthcare [ 3 , 4 ]. While the ISGPS definition for DGE is the most widely used, it relies on subjective clinical judgement and only diagnoses DGE at the end of the clinical course.…”

“…Delayed gastric emptying (DGE) is one of the most common complications following pancreaticoduodenectomy (PD), with postoperative DGE rates ranging between 10 and 45% [ 1 , 2 ]. DGE can significantly increase postoperative morbidity, prolong hospital stay and increase healthcare costs [ 3 , 4 ].…”

Cross-sectional imaging after pancreatic surgery: The dialogue between the radiologist and the surgeon

“…Three different grades (A, B, and C) were defined based on the impact on the clinical course and postoperative management, and even if DGE is a rarely life-threatening condition is usually associated with significant patient discomfort, prolonged hospital stay, and higher cost [66] .…”

Determination of the optimal reconstruction for pancreaticoduodenal resection based on modified scintigraphy of gastrointestinal motility

“…Среди специфических ослож нений ПДР выделяют панкреатическую фистулу, аррозивное кровотечение и послеоперационный гастростаз [3]. Послеоперационный гастростаз является частым осложнением ПДР и причиной продолжительного пребывания больных в стационаре после операции, повышенной стоимости лечения, частоты повторных госпитализаций и отсрочки лекарственной терапии [4]. Существуют клинические, лабораторные и инструментальные методы диагностики послеоперационного гастростаза.…”