The improvement in post-operative mortality following pancreaticoduodenectomy between 2006 and 2016 is associated with an improvement in the ability to rescue patients after major morbidity, not in the rate of major morbidity

Associations of gender, race, and ethnicity with disparities in short‐term adverse outcomes after pancreatic resection for cancer

“…The morbidities collected by ACS‐NSQIP are superficial surgical site infection (SSI), deep incisional SSI, organ space SSI, wound disruption, pneumonia, unplanned intubation, pulmonary embolism, ventilator dependence longer than 48 h, acute renal failure, renal insufficiency, urinary tract infection, cerebral vascular accident, cardiac arrest with cardiopulmonary resuscitation, myocardial infarction, deep venous thrombosis, sepsis, and septic shock. Major morbidities were defined as all complications excluding superficial SSI, renal insufficiency, urinary tract infection, and deep venous thrombosis based on a previously utilized definition 21–23 . Failure to rescue was a secondary outcome in this study and was defined as death in a patient with one or more of the defined major morbidities.…”

“…Multivariable models were constructed including all variables independent of significance on univariable analysis. Multivariable hierarchical logistic regression was used to estimate the odds of morbidity, major morbidity, mortality, and failure to rescue by first constructing a model utilizing all the other variables and then entering either gender, race, or ethnicity as the main variable of interest to assess for additional predictive ability 21–23 . The following variables were used in our models: age, body mass index (BMI), emergency case, operative approach, diabetes, smoking, dyspnea, functional status, ventilator‐dependent, history of chronic obstructive pulmonary disease (COPD), ascites, history of congestive heart failure, hypertensive medications, renal failure, dialysis, disseminated cancer, wound infection, steroid use, weight loss, bleeding disorder, transfusion requirement, preoperative sepsis, preoperative sodium, preoperative blood urea nitrogen (BUN), preoperative creatinine, preoperative albumin, preoperative total bilirubin, preoperative serum glutamic oxaloacetic transaminase (SGOT), preoperative alkaline phosphatase, preoperative jaundice, preoperative biliary stent placement, chemotherapy within 90 days, radiation therapy within 90 days, pancreatic duct size, pancreatic gland texture, malignant disease type, T (tumor) stage, N (node) stage, and M (metastases) stage.…”

“…Failure to rescue was a secondary outcome in this study and was defined as death in a patient with one or more of the defined major morbidities. The failure to rescue rate was calculated as the number of patients who died after major morbidity divided by the total number of patients who developed major morbidities 21–23 …”

Risk factors for postoperative cholangitis after pancreaticoduodenectomy and evaluation of internal stenting on hepaticojejunostomy: A single‐center propensity score‐based analysis

“…However, the postoperative morbidity rate of PD remains high. 1 Postoperative cholangitis (POC) is an early and late complication of biliary-enteric anastomosis (BEA), including PD. After BEA, duodenal papilla function is lost, and the intestinal contents easily reflux into the biliary duct.…”

“…The postoperative mortality rate after PD has decreased due to advances in surgical techniques and perioperative care. However, the postoperative morbidity rate of PD remains high 1 …”