Pancreatic debridement in a district general hospital - viable or vulnerable?
Pancreatic debridement in a district general hospital - viable or vulnerable?
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DOI：
10.1308/003588402760452394
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发表时间：
2002-09-01
影响因子：
1.4
通讯作者：
Alexander, DJ
中科院分区：
文献类型：
--
作者：
Catto, JWF;Alexander, DJ
对于地区综合医院 (DGH) 环境中胰腺清创术后的结果知之甚少，并且关于胰腺手术服务集中化的争论仍在继续。我们回顾了两年多的经验，特别关注死亡率、发病率和费用。在此期间治疗的12例中，8例为女性，7例为胆结石诱发。术前平均年龄为 56.5 岁，术前 Apache 11 评分为 15 分。术后发病率和死亡率分别为 67% 和 25%。一半进行指状坏死切除术，一半进行区域胰腺切除术。这些数字与文献中的其他数字相似（与 15 个当代系列进行比较）。每个患者的中位费用为 21,487 英镑，主要是由于国际电联的住宿费用（占总费用的 57.4%）。这与之前公布的其他费率以及我们当地高等教育中心的费率类似。结论是，在 DGH 中可以以经济可行的水平产生可接受的胰腺清创结果。
Little is known about the outcome after pancreatic debridement in the district general hospital (DGH) setting and the debate about centralisation of pancreatic surgical services continues. We retrospectively reviewed our experience over 2 years, looking particularly at mortality, morbidity and cost. Of 12 cases treated during this period, 8 were women and 7 were gallstone induced. The mean pre-operative age was 56.5 years and pre-operative Apache 11 score was 15. The rates for postoperative morbidity and mortality were 67% and 25%, respectively. In half, digital necrosectomy was performed and in half a regional pancreatic resection. These figures are similar to others found in the literature (comparison with 15 contemporary series). The median cost per patient was pound21,487, mainly due to ITU accommodation (57.4% of total costs). This is similar to other previously published rates and the rate from our local tertiary centre. It is concluded that acceptable results for pancreatic debridement are producible in the DGH at economically viable levels.