title: Impact of pancreatic head resection on direct medical costs in patients with chronic pancreatitis.
abstract: OBJECTIVE
  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).
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA. tjhoward@iupui.edu
authors.forename: T J
authors.initials: TJ
authors.lastname: Howard
authors.forename: J W
authors.initials: JW
authors.lastname: Jones
authors.forename: S
authors.initials: S
authors.lastname: Sherman
authors.forename: E
authors.initials: E
authors.lastname: Fogel
authors.forename: G A
authors.initials: GA
authors.lastname: Lehman
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010180:Pancreatectomy / Q000009:adverse effects / Q000191:economics*; D010195:Pancreatitis / Q000191:economics* / Q000601:surgery*