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Less morbidity after introduction of a new departmental policy for patients who undergo open distal pancreatectomy
Author(s) -
Yui Rintaro,
Satoi Sohei,
Toyokawa Hideyoshi,
Yanagimoto Hiroaki,
Yamamoto Tomohisa,
Hirooka Satoshi,
Yamaki So,
Ryota Hironori,
Michiura Taku,
Inoue Kentaro,
Matsui Yoichi,
Kwon AHon
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.4
Subject(s) - medicine , distal pancreatectomy , pancreatectomy , perioperative , surgery , abscess , group b , resection
Background The aim of this study was to retrospectively compare morbidity and mortality before and after introduction of a new departmental policy for patients who undergo distal pancreatectomy. Methods We have introduced the use of an ultrasonically‐activated device in distal pancreatectomy, an “early removal of drains” policy and perioperative management using a clinical pathway since M ay 2006. Group A consisted of 52 consecutive patients from 2000 to F ebruary 2006. Group B consisted of 57 consecutive patients from M ay 2006 to 2010. Results Although there was no difference in the fluid collection rate within 30 postoperative days (Group A, 44% vs. Group B , 35%), the rates of intra‐abdominal abscess (A, 19% vs. B, 4%) and grade 3/4 of the Clavien classification (A, 23% vs. B, 9%) in Group B were significantly lower than in Group A ( P < 0.05). Time of drain removal (median 3 days vs. 8 days) and length of in‐hospital stay (median 8 days vs. 17 days) in Group B were significantly shorter than in Group A ( P < 0.001). Conclusion The implementation of new departmental guidelines for distal pancreatectomy was closely associated with a low frequency of intra‐abdominal abscess and grade 3/4 Clavien score, resulting in a shorter in‐hospital stay.