Journal article
Minimally Invasive Hepatopancreatobiliary Surgery at a Large Regional Health System: Assessing the Safety of Program Expansion
The American surgeon, Vol.90(1), pp.85-91
Jan 2024
PMID: 37578387
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Complex, minimally invasive hepatopancreatobiliary surgery (MIS HPB) is safe at high-volume centers, yet outcomes during early implementation are unknown. We describe our experience during period of rapid growth in an MIS HPB program at a large regional health system.
During an increase in MIS HPB (60% greater from preceding year), hospital records of patients who underwent HPB surgery between 1/1/2019 and 12/31/2020 were reviewed. Operative time, estimated blood loss (EBL), conversion rates, length of stay (LOS), and perioperative outcomes were assessed.
267 patients' cases were reviewed. The population was 62 ± 13 years, 50% female, 90% white. MIS was more frequently performed for hepatic than pancreatic resections (59% vs 21%,
< .001). Open cases were more frequently performed for invasive malignancy in both pancreatic (70% vs 40%,
< .018) and hepatic (87% vs 70%,
= .046) resections. There was no difference in operative time between MIS and open surgery (293[218-355]min vs 296[199-399]min,
= .893). When compared to open, there was a shorter LOS (4[2-6]d vs 7[6-10]d,
< .001) and lower readmission rate (21% vs 37%,
= .005) following MIS. Estimated blood loss was lower in MIS liver resections, particularly when performed for benign disease (200[63-500]mL vs 600[200-1200]mL,
= .041). Overall 30-day mortality was similar between MIS and open surgery (1.0% vs 1.8%,
= 1.000).
During a surgical expansion phase within our regional health system, MIS HPB offered improved perioperative outcomes when compared to open surgery. These data support the safety of implementation even during intervals of rapid programmatic growth.
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Details
- Title
- Minimally Invasive Hepatopancreatobiliary Surgery at a Large Regional Health System: Assessing the Safety of Program Expansion
- Creators
- Samantha J Falls - Allegheny Health NetworkConor M Maxwell - Allegheny Health NetworkDylan J Kaye - Drexel University College of Medicine, Philadelphia, PA, USAShruti G Dighe - Allegheny Health NetworkSuzanne C Schiffman - Allegheny Health NetworkDavid L Bartlett - Allegheny Health NetworkPatrick L Wagner - Allegheny Health NetworkCasey J Allen - Allegheny Health Network
- Publication Details
- The American surgeon, Vol.90(1), pp.85-91
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001047869400001
- Scopus ID
- 2-s2.0-85168505784
- Other Identifier
- 991021861210904721
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- Web of Science research areas
- Surgery