Howard T J, Jones J W, Sherman S, Fogel E, Lehman G A
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Ann Surg. 2001 Nov;234(5):661-7. doi: 10.1097/00000658-200111000-00012.
To quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD).
Pancreatic head resection in selected patients with chronic pancreatitis provides pain relief and improves quality of life, but the effect on healthcare costs is unknown.
This observational cohort study comprised 34 selected patients with chronic pancreatitis followed up exclusively at the authors' institution treated by either DPPHR or PPPD between 1992 and 1997.
Twenty-one patients had DPPHR and 13 had PPPD. Patients in the PPPD group were slightly older, but other clinical characteristics were similar. Before surgery, the mean number of admissions per patient per year, days in the hospital per patient per year, and disease-specific hospital-based medical costs per patient per year were not significantly different between groups. After surgery, those three variables were similar between the groups but significantly less than preoperative values. Pain control remained significantly improved after 36 months of follow-up.
In selected patients with chronic pancreatitis, DPPHR and PPPD are equally effective in providing long-term pain relief and decreasing disease-specific hospital-based costs.
对34例慢性胰腺炎患者在接受保留十二指肠的胰头切除术(DPPHR)或保留幽门的胰十二指肠切除术(PPPD)治疗前后,以医院为基础的特定疾病医疗费用进行量化。
对部分慢性胰腺炎患者行胰头切除术可缓解疼痛并改善生活质量,但对医疗费用的影响尚不清楚。
这项观察性队列研究纳入了34例经选择的慢性胰腺炎患者,这些患者于1992年至1997年间在作者所在机构接受了DPPHR或PPPD治疗,并仅在该机构接受随访。
21例患者接受了DPPHR,13例患者接受了PPPD。PPPD组患者年龄稍大,但其他临床特征相似。手术前,两组患者每年的平均住院次数、每年的人均住院天数以及每年的人均特定疾病医院医疗费用无显著差异。手术后,两组的这三个变量相似,但均显著低于术前值。随访36个月后,疼痛控制仍有显著改善。
对于部分慢性胰腺炎患者,DPPHR和PPPD在提供长期疼痛缓解和降低特定疾病医院费用方面同样有效。