El Amrani M, Fulbert M, Lenne X, Clément G, Drumez E, Pruvot F-R, Truant S
Digestive Surgery and Transplantation Department, CHRU of Lille, avenue Michel-Polonowski, 59037 Lille, France; University of Lille, 59000 Lille, France.
Digestive Surgery and Transplantation Department, CHRU of Lille, avenue Michel-Polonowski, 59037 Lille, France; University of Lille, 59000 Lille, France.
J Visc Surg. 2018 Dec;155(6):465-470. doi: 10.1016/j.jviscsurg.2018.04.003. Epub 2018 Apr 26.
To define the cost of pancreatectomies and to identify factors associated with increased hospital costs after pancreatic resection.
All patients undergoing pancreatic surgery in our department between January 2008 and December 2014 were included. All complications occurring during hospitalization or in the 90-day period after discharge were documented. The hospital costs were analyzed and predictive factors of increased hospital costs were determined.
One hundred and twenty seven patients were identified. Most patients underwent pancreatectomy for malignant tumors (70%). Median hospital costs were 21,392 [15,998-29,667] euros. Age (P=0.011) and preoperative jaundice (P<0.001) were associated with higher hospital costs. Intraoperative surgical time and blood loss were correlated with increased costs (P=0.001 and P=0.002, respectively). Pancreatoduodenectomy was associated with statistically significantly higher costs compared to distal pancreatectomy (21,770 vs. 15,422 euros, P=0.001). Severe postoperative complications (Clavien-Dindo grade≥3) (P=0.001), septic complications (P=0.002) and hemorrhage (P=0.001) statistically significantly increased costs. In multivariate analysis, septic (P=0.003) and severe complications (P=0.01) were statistically significantly associated with increased hospital costs.
Pancreatic surgery is associated with high hospital costs, essentially related to postoperative complications.
确定胰腺切除术的成本，并找出胰腺切除术后医院成本增加的相关因素。
纳入2008年1月至2014年12月在我科接受胰腺手术的所有患者。记录住院期间或出院后90天内发生的所有并发症。分析医院成本并确定医院成本增加的预测因素。
共识别出127例患者。大多数患者因恶性肿瘤接受胰腺切除术（70%）。医院成本中位数为21392[15998 - 29667]欧元。年龄（P = 0.011）和术前黄疸（P < 0.001）与较高的医院成本相关。术中手术时间和失血量与成本增加相关（分别为P = 0.001和P = 0.002）。与胰体尾切除术相比，胰十二指肠切除术的成本在统计学上显著更高（21770欧元对15422欧元，P = 0.001）。术后严重并发症（Clavien-Dindo分级≥3）（P = 0.001）、感染性并发症（P = 0.002）和出血（P = 0.001）在统计学上显著增加成本。多因素分析中，感染性（P = 0.003）和严重并发症（P = 0.01）与医院成本增加在统计学上显著相关。
胰腺手术与高昂的医院成本相关，主要与术后并发症有关。
