An analysis of cost and clinical outcome in palliation for advanced pancreatic cancer

Melinda M. Mortenson, Hung S Ho, Richard J Bold

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: The optimal palliative method for patients with unresectable pancreatic cancer remains controversial. Methods: A retrospective chart review evaluated patients who underwent exploration for presumed resectable pancreatic cancer. Cost-based analysis was performed using relative value units (RVUs) that included the initial surgical procedure and any additional procedure required to achieve satisfactory palliation. Results: Of 96 patients (1993-2002), 6% had biliary bypass, 42% had duodenal bypass, 40% had double bypass, and 13% had no procedure with equivalent clinical outcomes. If biliary bypass was not initially performed, there was a significant incidence of biliary complications before definitive endoscopic stenting (P = .01). If duodenal bypass was not initially performed, 11% developed duodenal obstruction (P = .04). Total RVUs was highest for a double bypass and lowest for no initial surgical palliative procedure. Conclusions: Although surgical bypass procedures at initial exploration provide durable palliation, these procedures are associated with greater costs.

Original languageEnglish (US)
Pages (from-to)406-411
Number of pages6
JournalAmerican Journal of Surgery
Volume190
Issue number3
DOIs
StatePublished - Sep 2005

Keywords

  • Biliary obstruction
  • Gastric outlet obstruction
  • Pancreatic cancer

ASJC Scopus subject areas

  • Surgery

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