30-Day outcomes and predictors of complications after Puestow procedure.


Journal Article

BACKGROUND:A lateral pancreaticojejunostomy, or a Puestow procedure, is used in chronic pancreatitis with ductal dilation and pain. The current literature on the Puestow is sparse. This study examines outcomes of Puestow procedures nationwide. METHODS:Using ACS-NSQIP database, patients who underwent a Puestow procedure from 2010 to 2016 were identified. Univariate analysis and multivariable regression models were used to identify predictors of mortality and morbidities. Covariates included in the regression models were chosen based on clinical significance. RESULTS:The cohort included 524 patients. The 30-day mortality rate was 1.2%(n = 6). At least one major complication occurred in 19.1% of patients including death (1.2%), major organ dysfunction (8.2%), pulmonary embolism (1.3%), and surgical site infections (13.0%). Diabetes, COPD, and transfusions were the strongest predictors of complications. CONCLUSIONS:The Puestow procedure is an acceptable treatment modality with low rates of morbidity and mortality. Minimizing transfusions and optimizing pulmonary status may improve 30-day outcomes.

Full Text

Duke Authors

Cited Authors

  • Napolitano, M; Brody, F; Lee, KB; Rosenfeld, E; Chen, S; Murillo-Berlioz, AE; Amdur, R

Published Date

  • August 2020

Published In

Volume / Issue

  • 220 / 2

Start / End Page

  • 372 - 375

PubMed ID

  • 31894016

Pubmed Central ID

  • 31894016

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

International Standard Serial Number (ISSN)

  • 0002-9610

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2019.12.024


  • eng