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- W2894915730 abstract "Background: We sought to determine how postoperative complications impact the benefit of MIPD using the National Surgical Quality Improvement Program (NSQIP) database. Methods: All patients undergoing elective, non-hybrid MIPD (laparoscopic and robotic) and OPD in the 2014 and 2015 NSQIP pancreatectomy-specific database were included and their outcomes compared using univariate and multivariate analyses. Results: 7544 patient underwent PD – 7162 (94.9%) OPD and 382(5.1%) MIPD. There was no statistically significant difference in the overall rate of complications, length of stay (LOS), or 30-day mortality after MIPD compared to OPD. Patients undergoing MIPD had a significantly increased 30-day readmission rate (21.5% vs 16.5%, p = 0.012), and MIPD was independently associated with increased 30-day readmission (OR = 1.32, p = 0.033). However, MIPD patients who did not experience postoperative complications (n = 3624, 48%) had significantly shorter LOS (7.2 days vs 8.3 days, p = 0.003) and a reduced risk of being discharged to a facility other than home postoperatively (2.3% vs 8.6%, p = 0.003) compared with OPD patients without complications, and there was no difference in the rate of 30-day readmission or 30-day mortality. After risk adjustment, MIPD was independently associated with decreased LOS (mean difference = −1.2 days, p = 0.002) and decreased odds of being discharged to a facility other than home postoperatively (OR = 0.26, p = 0.001) in patients who did not experience postoperative complications. Conclusion: Among the roughly one-half of patients who do not experience postoperative complications after PD, the minimally invasive approach is associated with a decreased length of hospital stay and improved likelihood of being discharged home postoperatively." @default.
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- W2894915730 date "2018-09-01" @default.
- W2894915730 modified "2023-09-30" @default.
- W2894915730 title "The benefit of minimally invasive pancreaticoduodenectomy on enhanced recovery is restricted to patients who avoid postoperative complications" @default.
- W2894915730 doi "https://doi.org/10.1016/j.hpb.2018.06.2244" @default.
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