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Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis.

Publication ,  Journal Article
Barbas, AS; Speicher, PJ; Clary, BM
Published in: HPB (Oxford)
November 2014

BACKGROUND: Hepatic and pancreatic surgery is rarely performed in patients with end-stage renal disease (ESRD). The present authors used a national clinical database to characterize outcomes and perioperative risk in ESRD patients who require hepatic or pancreatic resection. METHODS: The 2005-2011 National Surgical Quality Improvement Program database was queried for all patients undergoing hepatic or pancreatic resection. Patients were classified by the presence or absence of ESRD. The independent effects of ESRD on outcomes were assessed after propensity score adjustment and multivariable logistic regression. RESULTS: Of the 27 376 patients submitted to hepatic or pancreatic procedures identified in the database, 101 patients were found to have preoperative ESRD. Patients with ESRD experienced perioperative mortality at a rate similar to that in those without ESRD (5.0% versus 2.3%; P = 0.08). After risk adjustment, the presence of ESRD was associated with three-fold higher odds of postoperative sepsis (adjusted odds ratio: 2.98, P = 0.014), but no significant differences in mortality or major complication rates. CONCLUSIONS: Hepatic and pancreatic resections can be performed safely in selected patients with ESRD. These patients may have an increased risk for the development of postoperative sepsis. Further study is needed to characterize modifiable risk factors that impact outcomes in patients with ESRD who require hepatic or pancreatic resection.

Duke Scholars

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

November 2014

Volume

16

Issue

11

Start / End Page

1016 / 1022

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Sepsis
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Propensity Score
  • Pancreatectomy
  • Odds Ratio
 

Citation

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Barbas, A. S., Speicher, P. J., & Clary, B. M. (2014). Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis. HPB (Oxford), 16(11), 1016–1022. https://doi.org/10.1111/hpb.12281
Barbas, Andrew S., Paul J. Speicher, and Bryan M. Clary. “Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis.HPB (Oxford) 16, no. 11 (November 2014): 1016–22. https://doi.org/10.1111/hpb.12281.
Barbas AS, Speicher PJ, Clary BM. Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis. HPB (Oxford). 2014 Nov;16(11):1016–22.
Barbas, Andrew S., et al. “Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis.HPB (Oxford), vol. 16, no. 11, Nov. 2014, pp. 1016–22. Pubmed, doi:10.1111/hpb.12281.
Barbas AS, Speicher PJ, Clary BM. Hepatic and pancreatic resection in patients with end-stage renal disease: a propensity analysis. HPB (Oxford). 2014 Nov;16(11):1016–1022.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

November 2014

Volume

16

Issue

11

Start / End Page

1016 / 1022

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Sepsis
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Propensity Score
  • Pancreatectomy
  • Odds Ratio