Surgeon Volume Versus Morbidity and Cost in Patients Undergoing Pancreaticoduodenectomy in an Academic Community Medical Center
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Despite trends toward regionalization of care, the majority of pancreaticoduodenectomies (PD) are performed in community hospitals by surgeons with varying degrees of experience. We analyzed the impact of several variables, including surgeon volume, on outcomes following PD within a high-volume community-based teaching hospital system.
Patients who underwent PD from 2005 to 2008 were reviewed retrospectively. Perioperative data, complications, and hospital financial data was queried. A high-volume (HV) surgeon was defined as an average of 10 or more PD per year.
Ninety-four patients underwent PD with an overall operative mortality rate of 9.6% (HV 2.2%, LV 16.0%), major complication rate of 32% (HV 18%, LV 44%), and median cost of $30,860 (HV $27,185, LV $33,007). Factors predictive of death were age (p < 0.02), body mass index (p < 0.01), and surgeon volume (p < 0.05). Factors predictive of major complication were surgeon volume (p < 0.01) and body mass index (p < 0.01). Factors predictive for increased length of stay for patients discharged from the hospital were surgeon volume (p < 0.02) and preoperative ASA classification (p < 0.05).
Surgeon volume and patient body mass index have a significant impact on perioperative morbidity following PD in a community teaching hospital.
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- Surgeon Volume Versus Morbidity and Cost in Patients Undergoing Pancreaticoduodenectomy in an Academic Community Medical Center
Journal of Gastrointestinal Surgery
Volume 14, Issue 12 , pp 1990-1996
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Cost analysis
- Surgical morbidity
- Surgeon volume
- Industry Sectors
- Author Affiliations
- 1. Hepatobiliary and Pancreatic Surgery Program, Providence Portland Medical Center, Portland, OR, USA
- 2. Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, Portland, OR, USA
- 3. Westside Surgical Division, The Oregon Clinic, Portland, OR, USA
- 4. Department of Surgery, Providence Medical Center, 4805 NE Glisan St., Suite 6N50, Portland, OR, 97213, USA