Takemura Yusuke, Endo Hideki, Hibi Taizo, Nakano Yutaka, Seishima Ryo, Takeuchi Masashi, Yamamoto Hiroyuki, Maeda Hiromichi, Hanazaki Kazuhiro, Taketomi Akinobu, Kakeji Yoshihiro, Seto Yasuyuki, Ueno Hideki, Mori Masaki, Kitagawa Yuko
Department of Surgery Keio University School of Medicine Tokyo Japan.
Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo Japan.
Ann Gastroenterol Surg. 2024 Mar 23;8(5):877-887. doi: 10.1002/ags3.12798. eCollection 2024 Sep.
The coronavirus disease 2019 (COVID-19) pandemic greatly impacted medical resources such as cancer screening, diagnosis, and treatment given to people for various diseases. We surveyed the impacts of the pandemic on the incidence of complications and mortality following pancreaticoduodenectomy for pancreatic cancer in Japan.
Data on patients who underwent pancreaticoduodenectomy for pancreatic cancer were extracted from the Japanese National Clinical Database (NCD) between 2018 and 2021. The number of the pancreaticoduodenectomy for pancreatic cancer were obtained and then the morbidity and mortality rates were evaluated using a standardized morbidity/mortality ratio (SMR), which is the ratio of the observed number of incidences to the expected number of incidences calculated by the risk calculator previously developed by the NCD.
This study included 22 255 cases. The number of pancreaticoduodenectomies exhibited an increasing trend even during the COVID-19 pandemic. The mean observed incidence rates of Grade C pancreatic fistula and Clavien-Dindo grade ≥4 complications, and the 30-day mortality and surgical mortality rates were 0.8%, 1.8%, 0.8% and 0.9%, respectively. The standardized morbidity ratios did not increase during the COVID-19 pandemic. The standardized mortality ratios remained within the range of variations observed before the COVID-19 pandemic.
The increasing trend in the number of pancreaticoduodenectomies and favorable short-term outcomes even in the COVID-19 pandemic suggest the medical care for pancreatic cancer in Japan functioned well during the pandemic.
2019年冠状病毒病（COVID-19）大流行对诸如癌症筛查、诊断以及针对各种疾病患者的治疗等医疗资源产生了重大影响。我们调查了该大流行对日本胰腺癌胰十二指肠切除术后并发症发生率和死亡率的影响。
从日本国家临床数据库（NCD）中提取2018年至2021年间接受胰腺癌胰十二指肠切除术患者的数据。获取胰腺癌胰十二指肠切除术的数量，然后使用标准化发病率/死亡率比（SMR）评估发病率和死亡率，SMR是观察到的发病数与由NCD先前开发的风险计算器计算出的预期发病数之比。
本研究纳入22255例病例。即使在COVID-19大流行期间，胰十二指肠切除术的数量也呈上升趋势。C级胰瘘和Clavien-Dindo≥4级并发症的平均观察发病率、30天死亡率和手术死亡率分别为0.8%、1.8%、0.8%和0.9%。在COVID-19大流行期间，标准化发病率比没有增加。标准化死亡率比仍在COVID-19大流行之前观察到的变化范围内。
胰十二指肠切除术数量的上升趋势以及即使在COVID-19大流行期间也有良好的短期结果表明，日本在大流行期间胰腺癌的医疗服务运行良好。
