Implications and cost of pancreatic leak following distal pancreatic resection

J. Rubén Rodríguez, Santos Soto Germes, Pari V. Pandharipande, G. Scott Gazelle, Sarah P. Thayer, Andrew L. Warshaw, Carlos Fernández-Del Castillo, Erwin Hirsch, Ronald Salem

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objectives: Pancreatic stump leak (PL) after elective distal pancreatic resection significantly impacts cost and increases subsequent health care resource utilization. We sought to provide an economic framework for potential interventions aimed at reducing its occurrence. Design: Retrospective case series and economic evaluation. Setting: University-affiliated, tertiary care referral center. Patients: Sixty-six patients undergoing elective distal pancreatectomy. Main Outcome Measures: Postoperative complications; hospital and professional costs. Results: Overall postoperative morbidity occurred in 34 patients (52%) with no deaths. The total number of patients with complications directly related to PL was 22 (33%). The mean±SD number of total hospital days for the no-PL group was 5.2±1.7 days (range, 3-12 days) vs 16.6±14.6 days (range, 4-49 days) for the PL group (P=.001). The average patient with PL-related problems incurred a total cost that was 2.01 times greater than the average patient in the no-PL group. A decision analytic model developed to evaluate threshold costs showed that a hypothetical intervention designed to reduce the complication rate of distal pancreatectomy by one third would be financially justifiable up to a cost of $1418 per patient. Conclusions: Complications derived from PL following distal pancreatectomy double the cost and dramatically increase health care resource utilization. There is an urgent need to develop strategies that reduce the incidence of this common complication. Interventions aimed at decreasing the incidence of PL should take into account this cost differential. We provide an economic model to serve as a guide for developing these technologies.

Original languageEnglish (US)
Pages (from-to)361-366
Number of pages6
JournalArchives of Surgery
Volume141
Issue number4
DOIs
StatePublished - Apr 1 2006

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Costs and Cost Analysis
Pancreatectomy
Patient Acceptance of Health Care
Health Resources
Tertiary Care Centers
Economic Models
Hospital Costs
Incidence
Cost-Benefit Analysis
Economics
Outcome Assessment (Health Care)
Technology
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

Rodríguez, J. R., Germes, S. S., Pandharipande, P. V., Gazelle, G. S., Thayer, S. P., Warshaw, A. L., ... Salem, R. (2006). Implications and cost of pancreatic leak following distal pancreatic resection. Archives of Surgery, 141(4), 361-366. https://doi.org/10.1001/archsurg.141.4.361

Implications and cost of pancreatic leak following distal pancreatic resection. / Rodríguez, J. Rubén; Germes, Santos Soto; Pandharipande, Pari V.; Gazelle, G. Scott; Thayer, Sarah P.; Warshaw, Andrew L.; Fernández-Del Castillo, Carlos; Hirsch, Erwin; Salem, Ronald.

In: Archives of Surgery, Vol. 141, No. 4, 01.04.2006, p. 361-366.

Research output: Contribution to journalArticle

Rodríguez, JR, Germes, SS, Pandharipande, PV, Gazelle, GS, Thayer, SP, Warshaw, AL, Fernández-Del Castillo, C, Hirsch, E & Salem, R 2006, 'Implications and cost of pancreatic leak following distal pancreatic resection', Archives of Surgery, vol. 141, no. 4, pp. 361-366. https://doi.org/10.1001/archsurg.141.4.361
Rodríguez JR, Germes SS, Pandharipande PV, Gazelle GS, Thayer SP, Warshaw AL et al. Implications and cost of pancreatic leak following distal pancreatic resection. Archives of Surgery. 2006 Apr 1;141(4):361-366. https://doi.org/10.1001/archsurg.141.4.361
Rodríguez, J. Rubén ; Germes, Santos Soto ; Pandharipande, Pari V. ; Gazelle, G. Scott ; Thayer, Sarah P. ; Warshaw, Andrew L. ; Fernández-Del Castillo, Carlos ; Hirsch, Erwin ; Salem, Ronald. / Implications and cost of pancreatic leak following distal pancreatic resection. In: Archives of Surgery. 2006 ; Vol. 141, No. 4. pp. 361-366.
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AU - Thayer, Sarah P.

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