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Unplanned Reoperation and Reintervention after Pancreatic Resections: An Analysis of Risk Factors

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Abstract

Background

The purpose of the study was to determine the incidence of any unplanned reoperation or reintervention procedure after pancreatic resection and to identify the underlying risk factors.

Methods

A total of 189 consecutive pancreatic resections performed from 2001–2008 were searched for any unplanned reoperation, percutaneous drainage, or angiographic reintervention. A retrospective analysis of a prospectively maintained database, including patient characteristics, comorbidities, details of surgery, specific complications, incidence of reoperation/reintervention, and mortality was performed.

Results

Overall rates of reoperation, reintervention, and mortality were 6.3% (12/189), 7.9% (15/189), and 1.6% (3/189), respectively. Four patients underwent reintervention and reoperation, so the combined reoperation/reintervention rate was 12.2% (23/189). Reoperation (P < 0.001) and reintervention (P = 0.002) correlated with mortality. Hemorrhage (relative risk [RR], 58; P = 0.0017) and the combination of hemorrhage and pancreatic fistula (RR, 117; P < 0.0001) were identified as risk factors for unplanned reoperation, hemorrhage (RR, 82; P = 0.005), pancreatic fistula (RR, 42; P < 0.001), and the combination of both complications (RR, 246; P < 0.001) for reoperation and/or reintervention. Other patient- or procedure-related factors did not influence the reoperation and/or reintervention rates significantly.

Conclusions

Pancreatic fistula and hemorrhage are the predominant factors that afford unplanned reoperation/reintervention. Although reporting the incidence of unplanned reoperation will include the most severe postoperative complications, a considerable number of reinterventions are missed. Therefore, in outcome analyses of pancreatic surgery, not only reoperations but also any interventional therapies should be included.

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Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Krankenhaus der Elisabethinen, Academic Teaching Hospital of the Medical Universities of Graz, Innsbruck and Vienna, Fadingerstrasse 1, 4020, Linz, Austria

    Odo Gangl, Uwe Fröschl, Wolfgang Hofer, Jürgen Huber & Reinhold Függer

  2. Department of Surgery, Krankenhaus St. Elisabeth, Landstraßer Hauptstrasse 4, 1030, Vienna, Austria

    Thomas Sautner

Authors
  1. Odo Gangl
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  2. Uwe Fröschl
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  3. Wolfgang Hofer
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  4. Jürgen Huber
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  5. Thomas Sautner
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  6. Reinhold Függer
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Correspondence to Odo Gangl.

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Gangl, O., Fröschl, U., Hofer, W. et al. Unplanned Reoperation and Reintervention after Pancreatic Resections: An Analysis of Risk Factors. World J Surg 35, 2306–2314 (2011). https://doi.org/10.1007/s00268-011-1213-5

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  • DOI: https://doi.org/10.1007/s00268-011-1213-5

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