Optimal Pancreatic Surgery

14:50 - 15:20, Room 104 (104講堂)

Chief Quality Officer
Temple University Health System



Henry A. Pitt


Chairman, Department of Surgery
National Taiwan University Hospital



Chiun-Sheng Huang


黃俊升 教授

Abstract - Optimal pancreatic surgery

       The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) was initiated in 2005. Within a few years, two-thirds of participating hospitals experienced reduced postoperative morbidity, and 82% of hospitals had reductions in mortality. By 2010, a risk calculator has been developed, and pancreatectomy-specific outcomes had been defined. In 2012, a Pancreatectomy Demonstration Project was accomplished at 43 hospitals with 24 procedure-specific variables including pancreatic fistula, delayed gastric emptying and pathology. In 2015, a Hepato-Pancreato-Biliary (HPB) Collaborative was initiated. By 2019, 165 hospitals in the USA (148), Canada (12), Australia (2), Lebanon (1), Jordan (1) and Singapore (1) were participating in the HPB Collaborative. In 2018, data on over 6,000 pancreatectomies were risk-adjusted and fed back to the participating hospitals. Multiple research papers have been published from the Demonstration Project as well as from the Participant Use File. One recent analysis in patients undergoing pancreatoduodenectomy (PD) demonstrated improved outcomes when drains were removed by postoperative day (POD) 3 when drain fluid amylase on POD 1 (DFA-1) was low. Another recent study in PD patients documented that superficial surgical site infections were reduced when a wound protector, a midline incision and broad-spectrum prophylactic antibiotics were utilized. Most recently, optimal pancreatic surgery was defined as no mortality, no serious morbidity, no need for postoperative percutaneous drainage or reoperation, a length of stay (LOS) below the 75th percentile and no readmission. From 2014-17, optimal surgery improved significantly (p<0.01) for both pancretoduodenectomy and distal pancreatectomy. Significant improvements in mortality, morbidity, percutaneous drainage, LOS and readmissions all contributed to the desirable outcomes.



NTUH International Forum of Digestive Surgery & TY Lin Symposium

2020 台大醫院一般外科忘年會

2020 NTUH General Surgery Celebration Event

Multidisciplinary approach in pancreatic cancer




January 18th, 2020


​台大醫學院 104 講堂

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