Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: This study evaluates leading causes of in-hospital mortality after pancreatic resection nationwide to determine areas for improvement. METHODS: This observational cohort study included all in-hospital mortality after pancreatic resection in the Netherlands (2014-2019). Each fatality was considered to be caused by local complications (i.e. directly related to surgery, located in surgical area) or systemic complications (e.g. cardiac or pulmonary). A blinded Expert Committee reviewed the postoperative course leading to death and identified potential quality improvement measures. RESULTS: Out of 5345 patients undergoing pancreatic resection, 149 patients (2.8 %) died in-hospital. Local complications caused death in 126 patients (85 %) and systemic complications in 23 patients (15 %). Concerning local complications, the common leading causes of death were postoperative pancreatic fistula (n = 41) and thrombosis of vascular reconstructions (n = 23). Systemic cardiac (n = 8) and pulmonary (n = 7) complications caused death frequently. Potential areas for improvement were failure to rescue (n = 89; 60 %), prevention of complications (n = 34, 23 %) and patient selection (n = 14; 9 %). CONCLUSION: Local complications often caused death after pancreatic resection, mainly pancreatic fistula and vascular reconstruction failure. Failure to rescue was considered the most important area for improvement to decrease in-hospital mortality further.
Source: HPB
Authors: Anne Claire Henry, F. Jasmijn Smits, Lois A. Daamen, Olivier R. Busch, Koop Bosscha, Ronald M. van Dam, Coen J.L. van Dam, Casper H. van Eijck, Sebastiaan Festen, Erwin van der Harst, Ignace H.J.T. de Hingh, Geert Kazemier, Mike S. Liem, Vincent E. de Meijer, Peter Noordzij, Gijs A. Patijn, Jennifer M.J. Schreinemakers, Martijn W.J. Stommel, Bert A. Bonsing, Bas G. Koerkamp, Marc G. Besselink, Robert C. Verdonk, Hjalmar C. van Santvoort, I. Quintus Molenaar
Institutions: University Medical Center Utrecht, St. Antonius Ziekenhuis, Amsterdam UMC Location University of Amsterdam, Cancer Center Amsterdam, Jeroen Bosch Ziekenhuis, Maastricht University Medical Centre, Erasmus MC, OLVG, Maasstad Ziekenhuis, Catharina Ziekenhuis, Amsterdam UMC Location Vrije Universiteit Amsterdam, Medisch Spectrum Twente, University Medical Center Groningen, University of Groningen, Isala, Amphia Ziekenhuis, Radboud University Nijmegen, Radboud University Medical Center, Leiden University Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,630
Funder: KWF Kankerbestrijding
OpenAlex ID: W4404893446