Anne Claire Henry , F. Jasmijn Smits , Lois A. Daamen , Olivier R. Busch , Koop Bosscha , Ronald M. van Dam , Coen J.L. van Dam , Casper H. van Eijck , Sebastiaan Festen , Erwin van der Harst , Ignace H.J.T. de Hingh , Geert Kazemier , Mike S. Liem , Vincent E. de Meijer , Peter Noordzij , Gijs A. Patijn , Jennifer M.J. Schreinemakers , Martijn W.J. Stommel , Bert A. Bonsing , Bas G. Koerkamp , I. Quintus Molenaar
{"title":"Root-cause analysis of mortality after pancreatic resection in a nationwide cohort","authors":"Anne Claire Henry , F. Jasmijn Smits , Lois A. Daamen , Olivier R. Busch , Koop Bosscha , Ronald M. van Dam , Coen J.L. van Dam , Casper H. van Eijck , Sebastiaan Festen , Erwin van der Harst , Ignace H.J.T. de Hingh , Geert Kazemier , Mike S. Liem , Vincent E. de Meijer , Peter Noordzij , Gijs A. Patijn , Jennifer M.J. Schreinemakers , Martijn W.J. Stommel , Bert A. Bonsing , Bas G. Koerkamp , I. Quintus Molenaar","doi":"10.1016/j.hpb.2024.11.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates leading causes of in-hospital mortality after pancreatic resection nationwide to determine areas for improvement.</div></div><div><h3>Methods</h3><div>This observational cohort study included all in-hospital mortality after pancreatic resection in the Netherlands (2014–2019). Each fatality was considered to be caused by local complications (i.e. directly related to surgery, located in surgical area) or systemic complications (e.g. cardiac or pulmonary). A blinded Expert Committee reviewed the postoperative course leading to death and identified potential quality improvement measures.</div></div><div><h3>Results</h3><div>Out of 5345 patients undergoing pancreatic resection, 149 patients (2.8 %) died in-hospital. Local complications caused death in 126 patients (85 %) and systemic complications in 23 patients (15 %). Concerning local complications, the common leading causes of death were postoperative pancreatic fistula (n = 41) and thrombosis of vascular reconstructions (n = 23). Systemic cardiac (n = 8) and pulmonary (n = 7) complications caused death frequently. Potential areas for improvement were failure to rescue (n = 89; 60 %), prevention of complications (n = 34, 23 %) and patient selection (n = 14; 9 %).</div></div><div><h3>Conclusion</h3><div>Local complications often caused death after pancreatic resection, mainly pancreatic fistula and vascular reconstruction failure. Failure to rescue was considered the most important area for improvement to decrease in-hospital mortality further.</div></div>","PeriodicalId":13229,"journal":{"name":"Hpb","volume":"27 4","pages":"Pages 461-469"},"PeriodicalIF":2.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1365182X24024298","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
This study evaluates leading causes of in-hospital mortality after pancreatic resection nationwide to determine areas for improvement.
Methods
This observational cohort study included all in-hospital mortality after pancreatic resection in the Netherlands (2014–2019). Each fatality was considered to be caused by local complications (i.e. directly related to surgery, located in surgical area) or systemic complications (e.g. cardiac or pulmonary). A blinded Expert Committee reviewed the postoperative course leading to death and identified potential quality improvement measures.
Results
Out of 5345 patients undergoing pancreatic resection, 149 patients (2.8 %) died in-hospital. Local complications caused death in 126 patients (85 %) and systemic complications in 23 patients (15 %). Concerning local complications, the common leading causes of death were postoperative pancreatic fistula (n = 41) and thrombosis of vascular reconstructions (n = 23). Systemic cardiac (n = 8) and pulmonary (n = 7) complications caused death frequently. Potential areas for improvement were failure to rescue (n = 89; 60 %), prevention of complications (n = 34, 23 %) and patient selection (n = 14; 9 %).
Conclusion
Local complications often caused death after pancreatic resection, mainly pancreatic fistula and vascular reconstruction failure. Failure to rescue was considered the most important area for improvement to decrease in-hospital mortality further.
期刊介绍:
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
Abstracted and Indexed in:
MEDLINE®
EMBASE
PubMed
Science Citation Index Expanded
Academic Search (EBSCO)
HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).