Title

30-Day outcomes and predictors of complications after Puestow procedure

Document Type

Journal Article

Publication Date

8-1-2020

Journal

American Journal of Surgery

Volume

220

Issue

2

DOI

10.1016/j.amjsurg.2019.12.024

Keywords

Chronic pancreatitis; Lateral pancreaticojejunostomy; NSQIP; Puestow

Abstract

© 2019 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.

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