Pancreatoduodenectomy with venous or arterial resection

A NSQIP propensity score analysis

Joal D. Beane, Michael House, Susan C. Pitt, Ben Zarzaur, E. Molly Kilbane, Bruce L. Hall, Taylor S. Riall, Henry A. Pitt

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. Methods: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2%) or with major venous (PD + V; 13.7%) or arterial (PD + A; 4.0%) vascular resection. Results: Postoperative morbidity and mortality following PD + A (51.0% and 3.6%) was comparable to PD + V (46.9% and 3.6%) and PD (44.3 and 1.5%, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2% vs 18.1%), deep venous thromboembolism (6.9% vs 0.9%), postoperative septic shock (6.9% vs 1.7%), and length of stay (12.2 vs 10 days) while overall morbidity (45.7% vs 46.6) and mortality (1.0% vs 0%) were comparable. Conclusions: Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased.

Original languageEnglish (US)
JournalHPB
DOIs
StateAccepted/In press - Jul 29 2016

Fingerprint

Propensity Score
Pancreaticoduodenectomy
Blood Vessels
Operative Time
Septic Shock
Morbidity
Mortality
Length of Stay
Pancreatectomy
Venous Thromboembolism
Quality Improvement
Venous Thrombosis
Blood Transfusion

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Beane, J. D., House, M., Pitt, S. C., Zarzaur, B., Kilbane, E. M., Hall, B. L., ... Pitt, H. A. (Accepted/In press). Pancreatoduodenectomy with venous or arterial resection: A NSQIP propensity score analysis. HPB. https://doi.org/10.1016/j.hpb.2016.11.013

Pancreatoduodenectomy with venous or arterial resection : A NSQIP propensity score analysis. / Beane, Joal D.; House, Michael; Pitt, Susan C.; Zarzaur, Ben; Kilbane, E. Molly; Hall, Bruce L.; Riall, Taylor S.; Pitt, Henry A.

In: HPB, 29.07.2016.

Research output: Contribution to journalArticle

Beane, Joal D. ; House, Michael ; Pitt, Susan C. ; Zarzaur, Ben ; Kilbane, E. Molly ; Hall, Bruce L. ; Riall, Taylor S. ; Pitt, Henry A. / Pancreatoduodenectomy with venous or arterial resection : A NSQIP propensity score analysis. In: HPB. 2016.
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abstract = "Introduction: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. Methods: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2{\%}) or with major venous (PD + V; 13.7{\%}) or arterial (PD + A; 4.0{\%}) vascular resection. Results: Postoperative morbidity and mortality following PD + A (51.0{\%} and 3.6{\%}) was comparable to PD + V (46.9{\%} and 3.6{\%}) and PD (44.3 and 1.5{\%}, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2{\%} vs 18.1{\%}), deep venous thromboembolism (6.9{\%} vs 0.9{\%}), postoperative septic shock (6.9{\%} vs 1.7{\%}), and length of stay (12.2 vs 10 days) while overall morbidity (45.7{\%} vs 46.6) and mortality (1.0{\%} vs 0{\%}) were comparable. Conclusions: Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased.",
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T2 - A NSQIP propensity score analysis

AU - Beane, Joal D.

AU - House, Michael

AU - Pitt, Susan C.

AU - Zarzaur, Ben

AU - Kilbane, E. Molly

AU - Hall, Bruce L.

AU - Riall, Taylor S.

AU - Pitt, Henry A.

PY - 2016/7/29

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N2 - Introduction: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. Methods: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2%) or with major venous (PD + V; 13.7%) or arterial (PD + A; 4.0%) vascular resection. Results: Postoperative morbidity and mortality following PD + A (51.0% and 3.6%) was comparable to PD + V (46.9% and 3.6%) and PD (44.3 and 1.5%, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2% vs 18.1%), deep venous thromboembolism (6.9% vs 0.9%), postoperative septic shock (6.9% vs 1.7%), and length of stay (12.2 vs 10 days) while overall morbidity (45.7% vs 46.6) and mortality (1.0% vs 0%) were comparable. Conclusions: Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased.

AB - Introduction: Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort. Methods: Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2%) or with major venous (PD + V; 13.7%) or arterial (PD + A; 4.0%) vascular resection. Results: Postoperative morbidity and mortality following PD + A (51.0% and 3.6%) was comparable to PD + V (46.9% and 3.6%) and PD (44.3 and 1.5%, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2% vs 18.1%), deep venous thromboembolism (6.9% vs 0.9%), postoperative septic shock (6.9% vs 1.7%), and length of stay (12.2 vs 10 days) while overall morbidity (45.7% vs 46.6) and mortality (1.0% vs 0%) were comparable. Conclusions: Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased.

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