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| Name | Class |
|---|---|
| Margarete-Ammon-Stiftung | UNKNOWN |
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The purpose of this study was to evaluate the real-world mortality rates of total pancreatectomy across Germany and to understand the impact of hospital caseload on surgical outcomes.
This retrospective observational study analyzed routine data from the nationwide German diagnosis-related group statistics, covering the years 2010 to 2020. The data included all inpatient episodes from acute care hospitals. The study focused on mortality rates associated with total pancreatectomy and examined how these rates varied with the complexity of the surgeries and the volume of procedures performed by different hospitals.
The mortality rates for total pancreatectomy in Germany were found to be more than three times higher than those reported by specialized pancreatic centers. Mortality rates increased significantly with the complexity of the total pancreatectomy procedures, especially those involving arterial resections. Hospitals with lower total pancreatectomy caseloads had higher mortality rates compared to high-volume centers.
Results showed that total pancreatectomies are associated with high mortality rates, particularly in hospitals with lower surgical volumes. The findings suggest that the promising outcomes from specialized centers cannot be generalized to all hospitals performing pancreatic surgeries, highlighting the need for a thorough understanding of the learning curve and specialization in pancreatic surgery to reduce mortality risks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Total pancreatectomy | Total pancreatectomy without vascular or adjacent organ resection. In cases with concomitant liver resection, only an excisional biopsy or wedge resection was to be performed |
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| Total pancreatectomy with venous resection | Total pancreatectomy with portal vein and/or superior mesenteric vein resection |
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| Total pancreatectomy with multivisceral resection | Total pancreatectomy with additional adjacent organ resection. The procedure extended beyond pylorus preserving, pylous resecting, and procedures with antrectomy and included the partial or total resection of additional organs with the exception of partial or total splenectomy. Procedures with liver resections, that required a larger atypical, segmental, bisegmental or major (hemihepatectomy) resection. |
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| Total pancreatectomy with arterial resection | Total pancreatectomy with arterial resection: superior mesenteric artery resections, hepatic artery resections, aortic resections, or resections of the celiac axis |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total pancreatectomy | Procedure | Surgical removal of the entire pancreas |
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| Measure | Description | Time Frame |
|---|---|---|
| In-hospital mortality | Death | 30 days |
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Inclusion Criteria:
Exclusion Criteria:
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The study population encompasses all patients that underwent total pancreatectomy in any German hospital (full survey of the German population).
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| Name | Affiliation | Role |
|---|---|---|
| Rene Mantke, MD, PhD | Head of Surgery at University Hospital Brandenburg an der Havel | Study Director |
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No Data is held by the Federal Statistical Office of Germany. Individual participant data is not available for data sharing.
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| ID | Term |
|---|---|
| D010182 | Pancreatic Diseases |
| ID | Term |
|---|---|
| D004066 | Digestive System Diseases |
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