Pancreatoduodenectomy—current status of surgical and perioperative techniques in Germany

Background Pancreatoduodenectomy in Germany is performed by a broad range of hospitals. A diversity of operative techniques is employed as no guidelines exist for intra- and perioperative management. We carried out a national survey to determine the de facto German standards for pancreatoduodenectom...

Full description

Saved in:
Bibliographic Details
Published in:Langenbeck's archives of surgery 2013-12, Vol.398 (8), p.1097-1105
Main Authors: Haane, Christina, Mardin, Wolf Arif, Schmitz, Britta, Dhayat, Sameer, Hummel, Richard, Senninger, Norbert, Schleicher, Christina, Mees, Soeren Torge
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
Certification
General Surgery
Germany - epidemiology
Hospitals - statistics & numerical data
Humans
Medicine
Medicine & Public Health
Original Article
Pancreatic Fistula - epidemiology
Pancreaticoduodenectomy - standards
Pancreaticoduodenectomy - statistics & numerical data
Pancreaticojejunostomy - standards
Pancreaticojejunostomy - statistics & numerical data
Postoperative Complications - epidemiology
Practice Patterns, Physicians' - statistics & numerical data
Surveys and Questionnaires
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
Workload - statistics & numerical data
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Pancreatoduodenectomy in Germany is performed by a broad range of hospitals. A diversity of operative techniques is employed as no guidelines exist for intra- and perioperative management. We carried out a national survey to determine the de facto German standards for pancreatoduodenectomy, assess quality assurance measures, and identify relevant issues for further investigation. Methods A questionnaire evaluating major outcome variables, case load, preferred surgical procedures, and perioperative management during pancreatoduodenectomy was developed and sent to 211 German hospitals performing >12 pancreatoduodenectomies per year (requirement for certification as a pancreas center). Statistical analysis was carried out using the Fisher Exact, Mann–Whitney U , and Spearman tests. Results The final response rate was 86 % (182/211). The preferred technique and de facto German standard for pancreatoduodenectomy was pylorus-preserving pancreatoduodenectomy with pancreatojejunostomy carried out via duct-to-mucosa anastomosis with interrupted sutures using PDS 4.0. The minority of German pancreas centers were certified (18–48 %). The certification rate increased with higher capacity levels and case load ( P  
ISSN:1435-2443
1435-2451
DOI:10.1007/s00423-013-1130-1