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The volume, cost and outcomes of pancreatic resection in a regional centre in New Zealand.

Authors
  • Wylie, Neil1
  • Hider, Phillip2
  • Armstrong, Delwyn1
  • Srinivasa, Sanket1
  • Rodgers, Michael1
  • Brown, Anna1
  • Koea, Jonathan1
  • 1 Upper Gastrointestinal Unit, Department of Surgery, North Shore Hospital, Auckland, New Zealand. , (New Zealand)
  • 2 Department of Population Health, University of Otago, Christchurch, New Zealand. , (New Zealand)
Type
Published Article
Journal
ANZ Journal of Surgery
Publisher
Wiley (Blackwell Publishing)
Publication Date
Dec 01, 2018
Volume
88
Issue
12
Pages
1258–1262
Identifiers
DOI: 10.1111/ans.13984
PMID: 28503843
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The frequency, costs and outcome of pancreatic resection (both pancreaticoduodenectomy and distal pancreatectomy) were reviewed in our own institution and correlated with regional population growth as well as national resection rates and locations. Demographic, pathological and outcome data on pancreaticoduodenectomy and distal pancreatectomy were obtained from a prospectively maintained database for the years 2005-2009 and 2010-2014. During this period, the catchment population grew from 460 000 to 567 000. Costing information was obtained from the hospital-independent costing and coding committee, and the locations and rates of pancreatic resection were obtained by interrogating the national minimum dataset. A total of 41 pancreatectomies (29 pancreaticoduodenectomy, 12 distal pancreatectomy) were performed between 2005 and 2009, increasing to 84 pancreatectomies (55 pancreaticoduodenectomies, 27 distal pancreatectomies and two total pancreatectomies) between 2010 and 2014. This constituted one sixth of the national volume of pancreatic resections. There was no difference in patient demographics or indications for resection between the two time periods; however, portal vein resection was used more frequently in the second period. Margin positivity rate decreased (7 of 41 versus 8 of 84) and lymph node harvest increased (median 8 nodes versus median 15 nodes) between the two time periods. Overall 30-day mortality was 1.6%. In New Zealand, regional rates of pancreatic resection reflect regional population demands, and institutional growth is driven by local population requirements. Institutional growth can be achieved with the maintenance of internationally accepted outcomes and quality indicators. © 2017 Royal Australasian College of Surgeons.

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