Day of surgery and mortality after pancreatoduodenectomy: A retrospective analysis of 29 270 surgical cases of pancreatic head cancer from Japan

Sunao Uemura, Hideki Endo, Nao Ichihara, Hiroaki Miyata, Hiromichi Maeda, Hiroshi Hasegawa, Kinji Kamiya, Yoshihiro Kakeji, Kazuhiro Yoshida, Seto Yasuyuki, Hiroki Yamaue, Masakazu Yamamoto, Yuko Kitagawa, Kazuhiro Hanazaki

研究成果: Article査読

抄録

Background/Purpose: The day of the week can impact medical treatment outcomes; however, few large-scale, disease-specific studies have focused on the association between the day of the week and mortality in patients after pancreatoduodenectomy for pancreatic head cancer. Methods: Data were obtained from the National Clinical Database. Twenty-two clinical variables were adopted for hierarchal logistic regression modeling to determine adjusted odds ratios (ORs) for surgical mortality after elective pancreatoduodenectomy. Results: The 30-day mortality and surgical mortality rates were 1.0% and 1.7%, respectively (n = 29 720). Surgeries were performed the least on Fridays (13.4%) compared with other weekdays. Crude rates of severe postoperative complications (mean, 14.1%; range, 13.5%-14.8%) and pancreatic fistulas (mean, 10.0%; range, 9.6%-10.3%) remained stable throughout the week. Unadjusted/adjusted ORs did not significantly differ between Friday and Monday (0.868, 95% CI: 0.636-1.173, P =.365, and 0.928, 95% CI: 0.668-1.287, P =.653, respectively), and results were similar for the remaining weekdays. Nineteen independent factors were associated with surgical mortality. Conclusions: The rate of perioperative mortality for elective pancreatoduodenectomy is low in Japan, with no evidence of disparities in surgical mortality rates between weekdays.

本文言語English
ジャーナルJournal of Hepato-Biliary-Pancreatic Sciences
DOI
出版ステータスAccepted/In press - 2021

ASJC Scopus subject areas

  • 外科
  • 肝臓学

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