Adding days spent in readmission to the initial postoperative length of stay limits the perceived benefit of laparoscopic distal pancreatectomy when compared with open distal pancreatectomy

• Published in: The American journal of surgery Vol. 201; no. 3; pp. 295 - 300
• Main Authors: Baker, Marshall S., M.D., M.B.A, Bentrem, David J., M.D, Ujiki, Michael B., M.D, Stocker, Susan, B.A., L.P.N, Talamonti, Mark S., M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2011; Elsevier; Elsevier Limited
• Subjects: Abdomen; Abdominal Abscess - etiology; Aged; Biological and medical sciences; Cardiovascular disease; Chronic obstructive pulmonary disease; Clinical outcomes; Comorbidity; Coronary vessels; Demographics; Diabetes; Digestive system. Abdomen; Electronic health records; Electronic medical records; Endoscopy; Female; Fistulae; General aspects; Hospitals; Humans; Hydration; Ileus - etiology; Infections; Intestinal Obstruction - etiology; Investigative techniques, diagnostic techniques (general aspects); Ischemia - etiology; Laparoscopic distal pancreatectomy; Laparoscopy; Laparoscopy - adverse effects; Length of Stay - statistics & numerical data; Liver, biliary tract, pancreas, portal circulation, spleen; Lymphatic system; Male; Medical records; Medical sciences; Middle Aged; Morbidity; Mortality; Open distal pancreatectomy; Pancreas; Pancreas neoplasm; Pancreatectomy; Pancreatectomy - adverse effects; Pancreatectomy - methods; Pancreatic cancer; Pancreatic Diseases - surgery; Pancreatic fistula; Pancreatic Fistula - etiology; Pancreatic Fistula - surgery; Pancreatic Neoplasms - surgery; Pancreatitis - surgery; Pathology; Patient Readmission - statistics & numerical data; Patients; Postoperative period; Postoperative readmission; Prospective Studies; Spleen; Spleen - blood supply; Studies; Suctioning; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Wound Infection - etiology; Treatment Outcome; Variables; Postoperative readmission; Pancreas neoplasm; Pancreatic fistula; Open distal pancreatectomy; Laparoscopic distal pancreatectomy; Postoperative; Residence time; readmission; Pancreatectomy; Duration; Fistula; Hospitalization; Laparoscopy; Medicine; Treatment; Efficiency; Surgery; Distal; Laparoscopic distal; Open distal; Perception; Tumor; Endoscopy; Limit; Pancreas; Comparative study
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.09.014

Abstract Background Published comparisons of laparoscopic (laparoscopic distal pancreatectomy [LDP]) to open distal pancreatectomy (ODP) identify improved lengths of stay (LOS) after LDP but do not include data on readmissions. Methods Demographic, operative, and postoperative outcomes data for patients undergoing LDP or ODP between August 2007 and December 2009 were culled from our prospectively accruing pancreatic database. Electronic medical records were reviewed to determine cause, treatment, and LOS for readmissions. Results Patients undergoing LDP were statistically identical to those undergoing ODP in regard to age, presentation, demographic characteristics, comorbidities, operative times, tumor sizes, morbidity, mortality, and pancreatic fistula rates. The initial LOS was statistically shorter for those undergoing LDP (4.8 ± .1 days vs 8.7 ± .1 days, P < .001). The readmission rate for LDP was statistically higher than for ODP (25% vs 8%, P < .05). Overall LOS for LDP was 7.2 ± .3 days versus 9.3 ± .1 days for ODP ( P = .2). Conclusions Adding readmission LOS to initial LOS eliminates the perceived effect of LDP to accelerate recovery.