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Open Access 01-09-2020 | Pancreatic Surgery | Original Article

Seasonal variations in pancreatic surgery outcome A retrospective time-trend analysis of 2748 Whipple procedures

Authors: Giovanni Marchegiani, Stefano Andrianello, Chiara Nessi, Tommaso Giuliani, Giuseppe Malleo, Salvatore Paiella, Roberto Salvia, Claudio Bassi

Published in: Updates in Surgery | Issue 3/2020

Abstract

Background

Observing cyclic patterns in surgical outcome is a common experience. We aimed to measure this phenomenon and to hypothesize possible causes using the experience of a high-volume pancreatic surgery department.

Methods

Outcomes of 2748 patients who underwent a Whipple procedure at a single high-volume center from January 2000 to December 2018 were retrospectively analyzed. Three different hypotheses were tested: the effect of climate changes, the “July effect” and the effect of vacations.

Results

Clavien-Dindo ≥ 3 morbidity was similar during warm vs. cold months (22.5% vs. 19.8%, p = 0.104) and at the beginning of activity of new trainees vs. the rest of the year (23.5 vs. 22.5%, p = 0.757). Patients operated when a high percentage of staff is on vacation showed an increased Clavien-Dindo ≥ 3 morbidity (22.3 vs. 18.5%, p = 0.022), but similar mortality (2.3 vs. 1.8%, p = 0.553). The surgical waiting list was also significantly longer during these periods (37 vs. 27 days, p = 0.037). Being operated in such a period of the year was an independent predictor of severe morbidity (OR 1.271, CI 95% 1.086–1.638, p = 0.031).

Conclusion

Being operated when more staff is on vacation significantly affects severe morbidity rate. Future healthcare system policies should prevent the relative shortage of resources during these periods.

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Title: Seasonal variations in pancreatic surgery outcome A retrospective time-trend analysis of 2748 Whipple procedures
Authors: Giovanni Marchegiani
Stefano Andrianello
Chiara Nessi
Tommaso Giuliani
Giuseppe Malleo
Salvatore Paiella
Roberto Salvia
Claudio Bassi
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Pancreatic Surgery
Pancreatic Surgery
Published in: Updates in Surgery / Issue 3/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00868-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Seasonal variations in pancreatic surgery outcome A retrospective time-trend analysis of 2748 Whipple procedures

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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