Highlights
- •A review of 524 patients who underwent a Puestow procedure from the NSQIP database.
- •Patient 30-day outcomes showed a 1.2% mortality and 19.1% morbidity rate.
- •Diabetes, COPD, and transfusions were the strongest predictors of complications.
Abstract
Background
A lateral pancreaticojejunostomy, or a Puestow procedure, is used in chronic pancreatitis
with ductal dilation and pain. The current literature on the Puestow is sparse. This
study examines outcomes of Puestow procedures nationwide.
Methods
Using ACS-NSQIP database, patients who underwent a Puestow procedure from 2010 to
2016 were identified. Univariate analysis and multivariable regression models were
used to identify predictors of mortality and morbidities. Covariates included in the
regression models were chosen based on clinical significance.
Results
The cohort included 524 patients. The 30-day mortality rate was 1.2%(n = 6). At least
one major complication occurred in 19.1% of patients including death (1.2%), major
organ dysfunction (8.2%), pulmonary embolism (1.3%), and surgical site infections
(13.0%). Diabetes, COPD, and transfusions were the strongest predictors of complications.
Conclusions
The Puestow procedure is an acceptable treatment modality with low rates of morbidity
and mortality. Minimizing transfusions and optimizing pulmonary status may improve
30-day outcomes.
Keywords
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Article info
Publication history
Published online: December 25, 2019
Accepted:
December 18,
2019
Received in revised form:
December 10,
2019
Received:
October 2,
2019
Identification
Copyright
Published by Elsevier Inc.
