National trends in resection of cystic lesions of the pancreas

Bradley N Reames, Christopher P. Scally, Timothy L. Frankel, Justin B. Dimick, Hari Nathan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Management of cystic lesions of the pancreas (CLP) is controversial. In this study, we sought to evaluate national changes in the resection of CLP over time, to better understand the impact of evolving guidelines on CLP management. Methods We used Medicare data to examine CLP resection among patients undergoing pancreatic resection between 2001 and 2012. Patients with a diagnosis of CLP were identified and compared to patients with non-CLP indications. We then examined changes over time in patient and hospital characteristics and outcomes among patients with a CLP diagnosis. Results We identified 56,419 Medicare patients undergoing pancreatic resection, of which 2129 had a CLP diagnosis. The annual number of CLP resections, and proportion of all resections performed for CLP increased significantly during the period, from 2.1% (65/3072) resections in 2001, to 4.5% (286/6348) in 2012 (p < 0.001). The proportion of CLP resections with a malignant diagnosis did not change (15.5% in 2001–2003 vs. 13.1% in 2010–2012, p = 0.4). Overall rates of 30-day mortality decreased significantly during the period (9.6% in 2001–2003 vs. 5.5% in 2010–2012, p < 0.001). Discussion CLP resections were performed with increasing frequency in Medicare patients between 2001 and 2012, but this did not correspond to increased diagnosis of malignancy. Additional research is needed to understand the influence of recent guidelines on management of CLP.

Original languageEnglish (US)
Pages (from-to)375-382
Number of pages8
JournalHPB
Volume18
Issue number4
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

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Pancreas
Medicare
Guidelines
Mortality

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Reames, B. N., Scally, C. P., Frankel, T. L., Dimick, J. B., & Nathan, H. (2016). National trends in resection of cystic lesions of the pancreas. HPB, 18(4), 375-382. https://doi.org/10.1016/j.hpb.2015.11.002

National trends in resection of cystic lesions of the pancreas. / Reames, Bradley N; Scally, Christopher P.; Frankel, Timothy L.; Dimick, Justin B.; Nathan, Hari.

In: HPB, Vol. 18, No. 4, 01.01.2016, p. 375-382.

Research output: Contribution to journalArticle

Reames, BN, Scally, CP, Frankel, TL, Dimick, JB & Nathan, H 2016, 'National trends in resection of cystic lesions of the pancreas', HPB, vol. 18, no. 4, pp. 375-382. https://doi.org/10.1016/j.hpb.2015.11.002
Reames, Bradley N ; Scally, Christopher P. ; Frankel, Timothy L. ; Dimick, Justin B. ; Nathan, Hari. / National trends in resection of cystic lesions of the pancreas. In: HPB. 2016 ; Vol. 18, No. 4. pp. 375-382.
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abstract = "Background Management of cystic lesions of the pancreas (CLP) is controversial. In this study, we sought to evaluate national changes in the resection of CLP over time, to better understand the impact of evolving guidelines on CLP management. Methods We used Medicare data to examine CLP resection among patients undergoing pancreatic resection between 2001 and 2012. Patients with a diagnosis of CLP were identified and compared to patients with non-CLP indications. We then examined changes over time in patient and hospital characteristics and outcomes among patients with a CLP diagnosis. Results We identified 56,419 Medicare patients undergoing pancreatic resection, of which 2129 had a CLP diagnosis. The annual number of CLP resections, and proportion of all resections performed for CLP increased significantly during the period, from 2.1{\%} (65/3072) resections in 2001, to 4.5{\%} (286/6348) in 2012 (p < 0.001). The proportion of CLP resections with a malignant diagnosis did not change (15.5{\%} in 2001–2003 vs. 13.1{\%} in 2010–2012, p = 0.4). Overall rates of 30-day mortality decreased significantly during the period (9.6{\%} in 2001–2003 vs. 5.5{\%} in 2010–2012, p < 0.001). Discussion CLP resections were performed with increasing frequency in Medicare patients between 2001 and 2012, but this did not correspond to increased diagnosis of malignancy. Additional research is needed to understand the influence of recent guidelines on management of CLP.",
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