1. Implementation of prospective, surgeon-driven, risk-based pathway for pancreatoduodenectomy results in improved clinical outcomes and first year cost savings of $1 million
- Author
-
Rory L. Smoot, Elizabeth B. Habermann, Michael L. Kendrick, Christopher R. Shubert, Florencia G. Que, Amy E. Glasgow, Bijan J. Borah, Sean P. Cleary, James P. Moriarty, Mark J. Truty, Michael B. Farnell, and David M. Nagorney
- Subjects
Male ,medicine.medical_specialty ,Average duration ,030230 surgery ,Risk Assessment ,Pancreaticoduodenectomy ,Odds ,Cohort Studies ,Pancreatic Fistula ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Blood loss ,Cost Savings ,Humans ,Medicine ,Aged ,medicine.diagnostic_test ,business.industry ,Surgical care ,Interventional radiology ,Health Care Costs ,Middle Aged ,medicine.disease ,Cost savings ,Treatment Outcome ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Cohort ,Emergency medicine ,Critical Pathways ,Female ,Surgery ,business - Abstract
BACKGROUND Morbidity and costs after pancreatoduodenectomy remain increased, driven by postoperative pancreatic fistula (POPF). A risk-based pathway for pancreatoduodenectomy (RBP-PD) was implemented and the clinical and cost outcomes compared with that of our historic practice. METHODS Prospective clinical and cost outcomes for our RBP-PD cohort treated from September 2014 to September 2015 were compared with a previously published cohort of pancreatoduodenectomies from January 2007 to February 2014. RESULTS A total of 128 RBP-PD cases were compared with 808 historic controls. Apart from less blood loss, there were no significant clinical differences between the 2 groups. Overall POPF rate did not change. Average duration of stay decreased to 10 days from 12 (P
- Published
- 2018
- Full Text
- View/download PDF