Predictors for readmission after pancreatic resection for malignancy.

Abstract

301 Background: Readmission after pancreatic resection has been reported as high as 50%. This study was undertaken to determine factors predicting readmission after pancreatic resection for malignancy. Methods: We reviewed the medical records of 202 patients to identify patients that had a pancreatic resection for malignancy between 2003 and 2010. Outcome measures included patient characteristics, medical comorbidities, and perioperative factors. Results: A total of 202 patients underwent pancreatic resection for malignancy. AJCC T stage was T1, T2, T3, and T4 in 10.9%, 26.3%, 52% and 9.2% respectively. Pancreatic head malignancies made up 84.8% of the patients, 2.3% were pancreatic neck, 8.4% were pancreatic body, and 4.5% were pancreatic tail primaries. Preoperative biliary stents were placed in 58% of patients. Adjuvant radiation and chemotherapy were given in 47.8 and 61.39% respectively. The readmission rate following resection was 20% at 60 days. The most common reasons for readmission within 60 days were delayed wound healing and renal insufficiency. On univariate analysis, factors predicting higher readmission rates included positive retroperitoneal margin (p=0.048), delayed gastric emptying (p=0.015), and presence of wound infection (p=0.0020). Conclusions: Factors related to tumor burden and GI/infectious complications were the most common predictors of readmission after pancreatic resection for malignancy. Though tumor size is a relatively immutable variable, improved management of postoperative complications remains an important factor in decreasing readmission rates after pancreatic resection for malignancy.