Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?

H. A. Pitt, A. S. Gomes, J. F. Lois, L. L. Mann, L. S. Deutsch, W. P. Longmire

Research output: Contribution to journalArticle

Abstract

Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage (PTD) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative PTD on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1% among 37 patients undergoing preoperative PTD, compared to 5.3% for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative PTD (57% versus 53%). However, total hospital stay was significantly longer (p <0.005) in the PTD group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the PTD procedure at our university medical center was over $8000 per patient. The authors conclude that preoperative PTD does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.

Original languageEnglish (US)
Pages (from-to)545-553
Number of pages9
JournalAnnals of Surgery
Volume201
Issue number5
StatePublished - 1985
Externally publishedYes

Fingerprint

Hospital Costs
Drainage
Morbidity
Mortality
Length of Stay
Perioperative Care
Obstructive Jaundice
Hospitalization
Retrospective Studies
Prospective Studies
Costs and Cost Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Pitt, H. A., Gomes, A. S., Lois, J. F., Mann, L. L., Deutsch, L. S., & Longmire, W. P. (1985). Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? Annals of Surgery, 201(5), 545-553.

Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? / Pitt, H. A.; Gomes, A. S.; Lois, J. F.; Mann, L. L.; Deutsch, L. S.; Longmire, W. P.

In: Annals of Surgery, Vol. 201, No. 5, 1985, p. 545-553.

Research output: Contribution to journalArticle

Pitt, HA, Gomes, AS, Lois, JF, Mann, LL, Deutsch, LS & Longmire, WP 1985, 'Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?', Annals of Surgery, vol. 201, no. 5, pp. 545-553.
Pitt HA, Gomes AS, Lois JF, Mann LL, Deutsch LS, Longmire WP. Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? Annals of Surgery. 1985;201(5):545-553.
Pitt, H. A. ; Gomes, A. S. ; Lois, J. F. ; Mann, L. L. ; Deutsch, L. S. ; Longmire, W. P. / Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?. In: Annals of Surgery. 1985 ; Vol. 201, No. 5. pp. 545-553.
@article{b746b916260c4c5ca663677d1c3b8732,
title = "Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?",
abstract = "Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage (PTD) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative PTD on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1{\%} among 37 patients undergoing preoperative PTD, compared to 5.3{\%} for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative PTD (57{\%} versus 53{\%}). However, total hospital stay was significantly longer (p <0.005) in the PTD group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the PTD procedure at our university medical center was over $8000 per patient. The authors conclude that preoperative PTD does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.",
author = "Pitt, {H. A.} and Gomes, {A. S.} and Lois, {J. F.} and Mann, {L. L.} and Deutsch, {L. S.} and Longmire, {W. P.}",
year = "1985",
language = "English (US)",
volume = "201",
pages = "545--553",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost?

AU - Pitt, H. A.

AU - Gomes, A. S.

AU - Lois, J. F.

AU - Mann, L. L.

AU - Deutsch, L. S.

AU - Longmire, W. P.

PY - 1985

Y1 - 1985

N2 - Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage (PTD) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative PTD on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1% among 37 patients undergoing preoperative PTD, compared to 5.3% for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative PTD (57% versus 53%). However, total hospital stay was significantly longer (p <0.005) in the PTD group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the PTD procedure at our university medical center was over $8000 per patient. The authors conclude that preoperative PTD does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.

AB - Despite recent advances in perioperative support care, surgery for obstructive jaundice is still associated with significant morbidity and mortality. For this reason, preoperative percutaneous transhepatic drainage (PTD) has been recommended for these patients. This method of management, however, has only been supported by retrospective and nonrandomized studies. Therefore, a prospective, randomized study was performed to determine the effect of preoperative PTD on operative mortality, morbidity, hospital stay, and hospital cost. Thirty-day mortality was 8.1% among 37 patients undergoing preoperative PTD, compared to 5.3% for 38 patients who went to surgery without preoperative drainage. Overall morbidity was also slightly, but not significantly, higher in patients who underwent preoperative PTD (57% versus 53%). However, total hospital stay was significantly longer (p <0.005) in the PTD group (31.4 days versus 23.1 days). The cost of this excess hospitalization and the PTD procedure at our university medical center was over $8000 per patient. The authors conclude that preoperative PTD does not reduce operative risk but does increase hospital cost and, therefore, should not be performed routinely.

UR - http://www.scopus.com/inward/record.url?scp=0021829215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021829215&partnerID=8YFLogxK

M3 - Article

C2 - 2986562

AN - SCOPUS:0021829215

VL - 201

SP - 545

EP - 553

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 5

ER -