[Pancreaticoduodenectomy in Denmark 2005-2008].
BACKGROUND
Pancreaticoduodenectomy (PD) is associated with high mortality and morbidity. Results can be optimised through centralisation and adjustment of perioperative care. The aim of this study was to describe organisation, postoperative stay, readmission and hospital mortality in the period 2005-2008 and to evaluate postoperative care and treatment after PD in 2007-2008.


METHODS
The study is based on data from the National Patient Registry for the period 2005-2008 and medical records for 2007-2008 from PD patients.


RESULTS
The median duration of postoperative stay in hospital 2005-2008 was 17 days (range 2-649). The readmission rate was 11%, and hospital mortality was 6%. In 2007-2008, both wound infections and intraabdominal abscesses were seen in 12% of cases, and anastomotic leakage of the hepaticojejunostomy and pancreaticojejunostomy occurred in 9% and 12% of cases, respectively. Four percent had no wound-related complications. Nasogastric and nasojejunal tubes were removed postoperatively on median day five and day six, respectively. Clear fluid intake began from median day five and solid food from day seven. The epidural catheter was removed on median day five and abdominal drains on day seven.


CONCLUSIONS
Mortality and postoperative hospital stay after PD were reduced in Denmark from the period 1996-2004 to 2005-2008, but the morbidity remains high. The results suggest a need for adjustment of perioperative care to current evidence-based care standards.
Brandsborg
Søren
S
Arhus Universitetshospital, Arhus Sygehus, Kirurgisk Afdeling L, Denmark.
Jensen
Lone Susanne
LS
Iversen
Maria Gerding
MG
Kehlet
Henrik
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D019990:Perioperative Care; D012042:Registries; D016896:Treatment Outcome; D055815:Young Adult