A comparison of open and minimally invasive surgery for hepatic and pancreatic resections using the nationwide inpatient sample

Aslam Ejaz, Teviah Sachs, Jin He, Gaya Spolverato, Kenzo Hirose, Nita Ahuja, Christopher Wolfgang, Martin A Makary, Matthew J Weiss, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background The use of minimally invasive surgery (MIS) techniques for pancreatic and liver operations remains ill defined. We sought to compare inpatient outcomes among patients undergoing open versus MIS pancreas and liver operations using a nationally representative cohort. Methods We queried the Nationwide Inpatient Sample database for all major pancreatic and hepatic resections performed between 2000 and 2011. Appropriate International Classification of Diseases, 9th Revision (ICD-9) coding modifiers for laparoscopy and robotic assist were used to categorize procedures as MIS. Demographics, comorbidities, and inpatient outcomes were compared between the open and MIS groups. Results A total of 65,033 resections were identified (pancreas, n = 36,195 [55.7%]; liver, n = 28,035 [43.1%]; combined pancreas and liver, n = 803 [1.2%]). The overwhelming majority of operations were performed open (n = 62,192, 95.6%), whereas 4.4% (n = 2,841) were MIS. The overall use of MIS increased from 2.3% in 2000 to 7.5% in 2011. Compared with patients undergoing an open operation, MIS patients were older and had a greater incidence of multiple comorbid conditions. After operation, the incidence of complications for MIS (pancreas, 35.4%; liver, 29.5%) was lower than for open (pancreas, 41.6%; liver, 33%) procedures (all P

Original languageEnglish (US)
Pages (from-to)538-547
Number of pages10
JournalSurgery
Volume156
Issue number3
DOIs
StatePublished - 2014

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Minimally Invasive Surgical Procedures
Inpatients
Liver
Pancreas
Incidence
Robotics
International Classification of Diseases
Laparoscopy
Comorbidity
Demography
Databases

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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A comparison of open and minimally invasive surgery for hepatic and pancreatic resections using the nationwide inpatient sample. / Ejaz, Aslam; Sachs, Teviah; He, Jin; Spolverato, Gaya; Hirose, Kenzo; Ahuja, Nita; Wolfgang, Christopher; Makary, Martin A; Weiss, Matthew J; Pawlik, Timothy M.

In: Surgery, Vol. 156, No. 3, 2014, p. 538-547.

Research output: Contribution to journalArticle

Ejaz, Aslam ; Sachs, Teviah ; He, Jin ; Spolverato, Gaya ; Hirose, Kenzo ; Ahuja, Nita ; Wolfgang, Christopher ; Makary, Martin A ; Weiss, Matthew J ; Pawlik, Timothy M. / A comparison of open and minimally invasive surgery for hepatic and pancreatic resections using the nationwide inpatient sample. In: Surgery. 2014 ; Vol. 156, No. 3. pp. 538-547.
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abstract = "Background The use of minimally invasive surgery (MIS) techniques for pancreatic and liver operations remains ill defined. We sought to compare inpatient outcomes among patients undergoing open versus MIS pancreas and liver operations using a nationally representative cohort. Methods We queried the Nationwide Inpatient Sample database for all major pancreatic and hepatic resections performed between 2000 and 2011. Appropriate International Classification of Diseases, 9th Revision (ICD-9) coding modifiers for laparoscopy and robotic assist were used to categorize procedures as MIS. Demographics, comorbidities, and inpatient outcomes were compared between the open and MIS groups. Results A total of 65,033 resections were identified (pancreas, n = 36,195 [55.7{\%}]; liver, n = 28,035 [43.1{\%}]; combined pancreas and liver, n = 803 [1.2{\%}]). The overwhelming majority of operations were performed open (n = 62,192, 95.6{\%}), whereas 4.4{\%} (n = 2,841) were MIS. The overall use of MIS increased from 2.3{\%} in 2000 to 7.5{\%} in 2011. Compared with patients undergoing an open operation, MIS patients were older and had a greater incidence of multiple comorbid conditions. After operation, the incidence of complications for MIS (pancreas, 35.4{\%}; liver, 29.5{\%}) was lower than for open (pancreas, 41.6{\%}; liver, 33{\%}) procedures (all P",
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AU - Ejaz, Aslam

AU - Sachs, Teviah

AU - He, Jin

AU - Spolverato, Gaya

AU - Hirose, Kenzo

AU - Ahuja, Nita

AU - Wolfgang, Christopher

AU - Makary, Martin A

AU - Weiss, Matthew J

AU - Pawlik, Timothy M.

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N2 - Background The use of minimally invasive surgery (MIS) techniques for pancreatic and liver operations remains ill defined. We sought to compare inpatient outcomes among patients undergoing open versus MIS pancreas and liver operations using a nationally representative cohort. Methods We queried the Nationwide Inpatient Sample database for all major pancreatic and hepatic resections performed between 2000 and 2011. Appropriate International Classification of Diseases, 9th Revision (ICD-9) coding modifiers for laparoscopy and robotic assist were used to categorize procedures as MIS. Demographics, comorbidities, and inpatient outcomes were compared between the open and MIS groups. Results A total of 65,033 resections were identified (pancreas, n = 36,195 [55.7%]; liver, n = 28,035 [43.1%]; combined pancreas and liver, n = 803 [1.2%]). The overwhelming majority of operations were performed open (n = 62,192, 95.6%), whereas 4.4% (n = 2,841) were MIS. The overall use of MIS increased from 2.3% in 2000 to 7.5% in 2011. Compared with patients undergoing an open operation, MIS patients were older and had a greater incidence of multiple comorbid conditions. After operation, the incidence of complications for MIS (pancreas, 35.4%; liver, 29.5%) was lower than for open (pancreas, 41.6%; liver, 33%) procedures (all P

AB - Background The use of minimally invasive surgery (MIS) techniques for pancreatic and liver operations remains ill defined. We sought to compare inpatient outcomes among patients undergoing open versus MIS pancreas and liver operations using a nationally representative cohort. Methods We queried the Nationwide Inpatient Sample database for all major pancreatic and hepatic resections performed between 2000 and 2011. Appropriate International Classification of Diseases, 9th Revision (ICD-9) coding modifiers for laparoscopy and robotic assist were used to categorize procedures as MIS. Demographics, comorbidities, and inpatient outcomes were compared between the open and MIS groups. Results A total of 65,033 resections were identified (pancreas, n = 36,195 [55.7%]; liver, n = 28,035 [43.1%]; combined pancreas and liver, n = 803 [1.2%]). The overwhelming majority of operations were performed open (n = 62,192, 95.6%), whereas 4.4% (n = 2,841) were MIS. The overall use of MIS increased from 2.3% in 2000 to 7.5% in 2011. Compared with patients undergoing an open operation, MIS patients were older and had a greater incidence of multiple comorbid conditions. After operation, the incidence of complications for MIS (pancreas, 35.4%; liver, 29.5%) was lower than for open (pancreas, 41.6%; liver, 33%) procedures (all P

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