Skip to main content
Journal cover image

Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes?

Publication ,  Journal Article
Baker, MS; Sherman, KL; Stocker, S; Hayman, AV; Bentrem, DJ; Prinz, RA; Talamonti, MS
Published in: J Gastrointest Surg
February 2013

INTRODUCTION: Established systems for grading postoperative complications do not change the assigned grade when multiple interventions or readmissions are required to manage a complication. Studies using these systems may misrepresent outcomes for the surgical procedures being evaluated. We define a quality outcome for distal pancreatectomy (DP) and use this metric to compare laparoscopic distal pancreatectomy (LDP) to open distal pancreatectomy (ODP). METHODS: Records for patients undergoing DP between January 2006 and December 2009 were reviewed. Clavien-Dindo grade IIIb, IV, and V complications were classified as severe adverse--poor quality--postoperative outcomes (SAPOs). II and IIIa complications requiring either significantly prolonged overall lengths of stay including readmissions within 90 days or more than one invasive intervention were also classified as SAPOs. RESULTS: By Clavien-Dindo system alone, 91 % of DP patients had either no complication or a low/moderate grade (I, II, IIIa) complication. Using our reclassification, however, 25 % had a SAPO. Patients undergoing LDP demonstrated a Clavien-Dindo complication profile identical to that for SDP but demonstrated significantly shorter overall lengths of stay, were less likely to require perioperative transfusion, and less likely to have a SAPO. CONCLUSIONS: Established systems undergrade the severity of some complications following DP. Using a procedure-specific metric for quality, we demonstrate that LDP affords a higher quality postoperative outcome than ODP.

Duke Scholars

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

February 2013

Volume

17

Issue

2

Start / End Page

273 / 280

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Quality Control
  • Prospective Studies
  • Postoperative Complications
  • Pancreatectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Baker, M. S., Sherman, K. L., Stocker, S., Hayman, A. V., Bentrem, D. J., Prinz, R. A., & Talamonti, M. S. (2013). Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes? J Gastrointest Surg, 17(2), 273–280. https://doi.org/10.1007/s11605-012-2104-2
Baker, Marshall S., Karen L. Sherman, Susan Stocker, Amanda V. Hayman, David J. Bentrem, Richard A. Prinz, and Mark S. Talamonti. “Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes?J Gastrointest Surg 17, no. 2 (February 2013): 273–80. https://doi.org/10.1007/s11605-012-2104-2.
Baker MS, Sherman KL, Stocker S, Hayman AV, Bentrem DJ, Prinz RA, et al. Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes? J Gastrointest Surg. 2013 Feb;17(2):273–80.
Baker, Marshall S., et al. “Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes?J Gastrointest Surg, vol. 17, no. 2, Feb. 2013, pp. 273–80. Pubmed, doi:10.1007/s11605-012-2104-2.
Baker MS, Sherman KL, Stocker S, Hayman AV, Bentrem DJ, Prinz RA, Talamonti MS. Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes? J Gastrointest Surg. 2013 Feb;17(2):273–280.
Journal cover image

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

February 2013

Volume

17

Issue

2

Start / End Page

273 / 280

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Quality Control
  • Prospective Studies
  • Postoperative Complications
  • Pancreatectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans