Pancreatic surgery

Evolution at a high-volume center

Kathryn M. Ziegler, Attila Nakeeb, Henry A. Pitt, C. Schmidt, Sarah N. Bishop, Jose Moreno, Jesus M. Matos, Nicholas Zyromski, Michael House, James A. Madura, Thomas Howard, Keith D. Lillemoe

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Advances in imaging, minimally invasive techniques, and regionalization have changed pancreatic surgery. Therefore, the aims of this report are to determine whether the pancreatic operations or the spectrum of disease have evolved at a high-volume center. Methods: From 1996 through 2009, 2,004 pancreatic operations were performed at Indiana University Hospital. The operations, pathology, and outcomes for 1996-2003 were compared with 2004-2009. Results: In 2004-2009, more operations/year were performed (215 vs 89; P < .01) and patients were older (58.8 years vs 55.8 years; P < .01). In recent years, more pancreatoduodenectomies (55.0% vs 50.4%) and fewer pancreatojejunostomies (6.2% vs 12.6%) and Beger/Frey procedures (2.6% vs 4.8%) were performed (P < .05). In 2004-2009, pylorus preservation (81.1% vs 64.4%), laparoscopic distal pancreatectomy (33.9% vs 0%), and splenic preservation (25.3% vs 2.2%) were carried out more frequently (P < .001). Pathology review revealed more tumors (68.8% vs 60.4%) and less pancreatitis (29.2% vs 34.4%; P < .01). Thirty-day mortality improved from 2.5% to 1.8%. Conclusion: At a high-volume pancreatic surgery center, the number and age of the patients, the percentage of pancreatic resections, preservation of the pylorus and spleen as well as laparoscopic procedures, and the percentage of patients with tumors all have increased, whereas the outcomes continued to improve.

Original languageEnglish
Pages (from-to)702-710
Number of pages9
JournalSurgery
Volume148
Issue number4
DOIs
StatePublished - Oct 2010

Fingerprint

Pylorus
Pancreaticojejunostomy
Pathology
Pancreatectomy
Pancreaticoduodenectomy
Pancreatitis
Neoplasms
Spleen
Mortality

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Ziegler, K. M., Nakeeb, A., Pitt, H. A., Schmidt, C., Bishop, S. N., Moreno, J., ... Lillemoe, K. D. (2010). Pancreatic surgery: Evolution at a high-volume center. Surgery, 148(4), 702-710. https://doi.org/10.1016/j.surg.2010.07.029

Pancreatic surgery : Evolution at a high-volume center. / Ziegler, Kathryn M.; Nakeeb, Attila; Pitt, Henry A.; Schmidt, C.; Bishop, Sarah N.; Moreno, Jose; Matos, Jesus M.; Zyromski, Nicholas; House, Michael; Madura, James A.; Howard, Thomas; Lillemoe, Keith D.

In: Surgery, Vol. 148, No. 4, 10.2010, p. 702-710.

Research output: Contribution to journalArticle

Ziegler, KM, Nakeeb, A, Pitt, HA, Schmidt, C, Bishop, SN, Moreno, J, Matos, JM, Zyromski, N, House, M, Madura, JA, Howard, T & Lillemoe, KD 2010, 'Pancreatic surgery: Evolution at a high-volume center', Surgery, vol. 148, no. 4, pp. 702-710. https://doi.org/10.1016/j.surg.2010.07.029
Ziegler, Kathryn M. ; Nakeeb, Attila ; Pitt, Henry A. ; Schmidt, C. ; Bishop, Sarah N. ; Moreno, Jose ; Matos, Jesus M. ; Zyromski, Nicholas ; House, Michael ; Madura, James A. ; Howard, Thomas ; Lillemoe, Keith D. / Pancreatic surgery : Evolution at a high-volume center. In: Surgery. 2010 ; Vol. 148, No. 4. pp. 702-710.
@article{9e8afffbb4ce4bc0809e29a7a58de7fa,
title = "Pancreatic surgery: Evolution at a high-volume center",
abstract = "Background: Advances in imaging, minimally invasive techniques, and regionalization have changed pancreatic surgery. Therefore, the aims of this report are to determine whether the pancreatic operations or the spectrum of disease have evolved at a high-volume center. Methods: From 1996 through 2009, 2,004 pancreatic operations were performed at Indiana University Hospital. The operations, pathology, and outcomes for 1996-2003 were compared with 2004-2009. Results: In 2004-2009, more operations/year were performed (215 vs 89; P < .01) and patients were older (58.8 years vs 55.8 years; P < .01). In recent years, more pancreatoduodenectomies (55.0{\%} vs 50.4{\%}) and fewer pancreatojejunostomies (6.2{\%} vs 12.6{\%}) and Beger/Frey procedures (2.6{\%} vs 4.8{\%}) were performed (P < .05). In 2004-2009, pylorus preservation (81.1{\%} vs 64.4{\%}), laparoscopic distal pancreatectomy (33.9{\%} vs 0{\%}), and splenic preservation (25.3{\%} vs 2.2{\%}) were carried out more frequently (P < .001). Pathology review revealed more tumors (68.8{\%} vs 60.4{\%}) and less pancreatitis (29.2{\%} vs 34.4{\%}; P < .01). Thirty-day mortality improved from 2.5{\%} to 1.8{\%}. Conclusion: At a high-volume pancreatic surgery center, the number and age of the patients, the percentage of pancreatic resections, preservation of the pylorus and spleen as well as laparoscopic procedures, and the percentage of patients with tumors all have increased, whereas the outcomes continued to improve.",
author = "Ziegler, {Kathryn M.} and Attila Nakeeb and Pitt, {Henry A.} and C. Schmidt and Bishop, {Sarah N.} and Jose Moreno and Matos, {Jesus M.} and Nicholas Zyromski and Michael House and Madura, {James A.} and Thomas Howard and Lillemoe, {Keith D.}",
year = "2010",
month = "10",
doi = "10.1016/j.surg.2010.07.029",
language = "English",
volume = "148",
pages = "702--710",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Pancreatic surgery

T2 - Evolution at a high-volume center

AU - Ziegler, Kathryn M.

AU - Nakeeb, Attila

AU - Pitt, Henry A.

AU - Schmidt, C.

AU - Bishop, Sarah N.

AU - Moreno, Jose

AU - Matos, Jesus M.

AU - Zyromski, Nicholas

AU - House, Michael

AU - Madura, James A.

AU - Howard, Thomas

AU - Lillemoe, Keith D.

PY - 2010/10

Y1 - 2010/10

N2 - Background: Advances in imaging, minimally invasive techniques, and regionalization have changed pancreatic surgery. Therefore, the aims of this report are to determine whether the pancreatic operations or the spectrum of disease have evolved at a high-volume center. Methods: From 1996 through 2009, 2,004 pancreatic operations were performed at Indiana University Hospital. The operations, pathology, and outcomes for 1996-2003 were compared with 2004-2009. Results: In 2004-2009, more operations/year were performed (215 vs 89; P < .01) and patients were older (58.8 years vs 55.8 years; P < .01). In recent years, more pancreatoduodenectomies (55.0% vs 50.4%) and fewer pancreatojejunostomies (6.2% vs 12.6%) and Beger/Frey procedures (2.6% vs 4.8%) were performed (P < .05). In 2004-2009, pylorus preservation (81.1% vs 64.4%), laparoscopic distal pancreatectomy (33.9% vs 0%), and splenic preservation (25.3% vs 2.2%) were carried out more frequently (P < .001). Pathology review revealed more tumors (68.8% vs 60.4%) and less pancreatitis (29.2% vs 34.4%; P < .01). Thirty-day mortality improved from 2.5% to 1.8%. Conclusion: At a high-volume pancreatic surgery center, the number and age of the patients, the percentage of pancreatic resections, preservation of the pylorus and spleen as well as laparoscopic procedures, and the percentage of patients with tumors all have increased, whereas the outcomes continued to improve.

AB - Background: Advances in imaging, minimally invasive techniques, and regionalization have changed pancreatic surgery. Therefore, the aims of this report are to determine whether the pancreatic operations or the spectrum of disease have evolved at a high-volume center. Methods: From 1996 through 2009, 2,004 pancreatic operations were performed at Indiana University Hospital. The operations, pathology, and outcomes for 1996-2003 were compared with 2004-2009. Results: In 2004-2009, more operations/year were performed (215 vs 89; P < .01) and patients were older (58.8 years vs 55.8 years; P < .01). In recent years, more pancreatoduodenectomies (55.0% vs 50.4%) and fewer pancreatojejunostomies (6.2% vs 12.6%) and Beger/Frey procedures (2.6% vs 4.8%) were performed (P < .05). In 2004-2009, pylorus preservation (81.1% vs 64.4%), laparoscopic distal pancreatectomy (33.9% vs 0%), and splenic preservation (25.3% vs 2.2%) were carried out more frequently (P < .001). Pathology review revealed more tumors (68.8% vs 60.4%) and less pancreatitis (29.2% vs 34.4%; P < .01). Thirty-day mortality improved from 2.5% to 1.8%. Conclusion: At a high-volume pancreatic surgery center, the number and age of the patients, the percentage of pancreatic resections, preservation of the pylorus and spleen as well as laparoscopic procedures, and the percentage of patients with tumors all have increased, whereas the outcomes continued to improve.

UR - http://www.scopus.com/inward/record.url?scp=77956650896&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956650896&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2010.07.029

DO - 10.1016/j.surg.2010.07.029

M3 - Article

VL - 148

SP - 702

EP - 710

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 4

ER -