Outcome after pancreaticoduodenectomy for periampullary cancer: An analysis from the Veterans Affairs National Surgical Quality Improvement Program

Kevin Billingsley, Kwan Hur, William G. Henderson, Jennifer Daley, Shukri F. Khuri, Richard H. Bell

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The aim of this study is to define the risk factors that predict adverse outcomes for patients undergoing pancreaticoduodenectomy for periampullary cancer in the Department of Veterans Affairs Healthcare System (VA). The VA National Surgical Quality Improvement Program prospectively collected data on 462 patients undergoing pancreaticoduodenectomy in 123 VA medical centers from 1990 to 2000. Independent variables included 68 preoperative and 12 intraoperative variables. The main outcome measures were 30-day postoperative mortality and morbidity, as measured by a set of 20 pre-defined complications. Predictive models for 30-day morbidity and mortality were constructed using logistic regression analysis. The 30-day morbidity rate was 45.9% (212/462). The 30-day postoperative mortality rate was 9.3% (43/462). Significant predictors of mortality included: preoperative serum albumin, American Society of Anesthesiologists classification, preoperative bilirubin >20mg/dl, and operative time. The use of preoperative biliary tract instrumentation did not predict postoperative death or septic complications. This study provides a set of preoperative risk factors that are predictive of adverse outcome following pancreaticoduodenectomy. These factors may assist in patient selection for this procedure and are likely to facilitate risk-adjusted comparison of pancreaticoduodenectomy outcomes between different health care systems.

Original languageEnglish (US)
Pages (from-to)484-491
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume7
Issue number4
DOIs
StatePublished - May 2003
Externally publishedYes

Fingerprint

Pancreaticoduodenectomy
Veterans
Quality Improvement
Mortality
Morbidity
Neoplasms
Delivery of Health Care
Biliary Tract
Operative Time
Bilirubin
Serum Albumin
Patient Selection
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)

Keywords

  • Adverse effects
  • Pancreatic neoplasms
  • Postoperative complications
  • Surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Outcome after pancreaticoduodenectomy for periampullary cancer : An analysis from the Veterans Affairs National Surgical Quality Improvement Program. / Billingsley, Kevin; Hur, Kwan; Henderson, William G.; Daley, Jennifer; Khuri, Shukri F.; Bell, Richard H.

In: Journal of Gastrointestinal Surgery, Vol. 7, No. 4, 05.2003, p. 484-491.

Research output: Contribution to journalArticle

Billingsley, Kevin ; Hur, Kwan ; Henderson, William G. ; Daley, Jennifer ; Khuri, Shukri F. ; Bell, Richard H. / Outcome after pancreaticoduodenectomy for periampullary cancer : An analysis from the Veterans Affairs National Surgical Quality Improvement Program. In: Journal of Gastrointestinal Surgery. 2003 ; Vol. 7, No. 4. pp. 484-491.
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