ArticleSurgery2018
Risk-stratified clinical pathways decrease the duration of hospitalization and costs of perioperative care after pancreatectomy.
Article in Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Clinical pathways for secondary care and the effects on professional practice, patient outcomes, length of stay and hospital costs.The Cochrane database of systematic reviews · 2025Pooled it
- Piperacillin/tazobactam for surgical prophylaxis during pancreatoduodenectomy: meta-analysis.BJS open · 2024Pooled it
- Efficacy of gastric decompression after pancreatic surgery: a systematic review and meta-analysis.BMC gastroenterology · 2020Pooled it
- Short-Term Outcomes and Cost of Robotic Versus Open Distal Pancreatectomy During the Initial Phase of a Robotic Pancreatectomy Program.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Longitudinal Symptom Recovery After Pancreatectomy: A Prospective Patient-Reported Outcomes Study using MDASI.Annals of surgical oncology · 2026Article
- Association Between Intraoperative Hypothermia and Postoperative Pancreatic Fistula.Annals of surgical oncology · 2025Article
- Analysis of hospital costs for robotic and open pancreatectomy incurred during the implementation of a robotic pancreatectomy program at a cancer center.Annals of gastroenterological surgery · 2025Article
- Exploring patient's clinical outcomes, hospital costs, and satisfaction after the implementation of integrated clinical pathway-based nursing practice model.Cost effectiveness and resource allocation : C/E · 2025Article
- Persistent Improvement in Opioid Perceptions and Prescribing for Cancer Surgery: 5-Year Follow-Up.Advances in cancer education and quality improvement · 2025Article
- Impact of Nonhepatectomy Opioid Reduction Efforts on Posthepatectomy Opioid Prescription: Analysis of 2,005 Patients.Journal of the American College of Surgeons · 2025Article
- The Impact of Intraoperative Anesthesiology Provider Handovers on Postoperative Complications After Hepatopancreatobiliary (HPB) Surgery.Journal of surgical oncology · 2025Article
- Challenges and opportunities in enhanced recovery after surgery programs: An overview.Indian journal of anaesthesia · 2024Review
- Laparoscopic transverse abdominis plane block: how I do it and a cost efficiency analysis.Langenbeck's archives of surgery · 2023Article
- Evaluation and Recalibration of Risk-Stratified Pancreatoduodenectomy Drain Fluid Amylase Removal Criteria.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Postoperative Opioid Use Is Associated with Increased Rates of Grade B/C Pancreatic Fistula After Distal Pancreatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Risk stratification of clinically relevant delayed gastric emptying after pancreaticoduodenectomy.BMC surgery · 2023Article
- Comparative analysis of opioid use between robotic and open pancreatoduodenectomy.Journal of hepato-biliary-pancreatic sciences · 2023Article
- Incidence of Postoperative Complications Following Pancreatectomy for Pancreatic Cystic Lesions or Pancreatic Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Surgical approach to pancreaticoduodenectomy for pancreatic adenocarcinoma: uncomplicated ends justify the means.Surgical endoscopy · 2022Article
- Risk-stratified posthepatectomy pathways based upon the Kawaguchi-Gayet complexity classification and impact on length of stay.Surgery open science · 2022Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPostoperative pancreatic fistula is associated with adverse events, increased duration of stay and hospital costs. We developed perioperative care pathways stratified by postoperative pancreatic fistula risk with the aims of minimizing variations in care, improving quality, and decreasing costs. STUDY
designThree unique risk-stratified pancreatectomy clinical pathways-low-risk pancreatoduodenectomy, high-risk pancreatoduodenectomy, and distal pancreatectomy were developed and implemented. Consecutive patients treated after implementation of the risk-stratified pancreatectomy clinical pathways were compared with patients treated immediately prior. Duration of stay, rates of perioperative adverse effects, discharge disposition, and hospital readmission, as well as the associated costs of care, were evaluated.
resultsThe median hospital stay after pancreatectomy decreased from 10 to 6 days after implementation of the risk-stratified pancreatectomy clinical pathways (P < .001), and the median cost of index hospitalization decreased by 22%. Decreased changes in median hospital stay and costs of hospitalization were observed in association with low-risk pancreatoduodenectomy (P < .05) and distal pancreatectomy (P < .05), but not high-risk pancreatoduodenectomy. The rates of 90-day adverse events, grade B/C postoperative pancreatic fistula, discharge to a facility other than home, or readmission did not change after implementation.
conclusionImplementation of risk-stratified pancreatectomy clinical pathways decreased median stay and cost of index hospitalization after pancreatectomy without unfavorably affecting rates of perioperative adverse events or readmission, or discharge disposition. Outcomes were most favorably improved for low-risk pancreatoduodenectomy and distal pancreatectomy. Additional work is necessary to decrease the rate of postoperative pancreatic fistula, minimize variability, and improve outcomes after high-risk pancreatoduodenectomy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.