Less morbidity after introduction of a new departmental policy for patients who undergo open distal pancreatectomy. Issue 1 (27th June 2013)

• Record Type: Journal Article
• Authors: Yui, Rintaro; Satoi, Sohei; Toyokawa, Hideyoshi; Yanagimoto, Hiroaki; Yamamoto, Tomohisa; Hirooka, Satoshi; Yamaki, So; Ryota, Hironori; Michiura, Taku; Inoue, Kentaro; Matsui, Yoichi; Kwon, A‐Hon
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 21:Issue 1(2014)
• Page Start: 72
• Page End: 77
• Publication Date: 2013-06-27
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.4
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp4-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="jhbp4-sec-0002" sec-type="section"> <title>Methods</title> <p>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 May 2006. Group A consisted of 52 consecutive patients from 2000 to February 2006. Group B consisted of 57 consecutive patients from May 2006 to 2010.</p> </sec> <sec id="jhbp4-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> < 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 (<italic>P</italic> < 0.001).</p> </sec> <sec id="jhbp4-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>