000			03479nam a22004457a 4500
008			241030s20242024 xxu||||| |||| 00| 0 eng d
022			_a0039-6060
024			_aS0039-6060(24)00475-6 [pii]
040			_aOvid MEDLINE(R)
099			_a39048330
245			_aThe utility of axial imaging among selected patients in the early postoperative period after pancreatectomy.
251			_aSurgery. 2024 Jul 23
252			_aSurgery. 2024 Jul 23
253			_aSurgery
260			_c2024
260			_fFY2025
260			_p2024 Jul 23
265			_saheadofprint
265			_tPublisher
266			_d2024-10-30
266			_z2024/07/24 21:52
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aBACKGROUND: Postoperative computed tomography imaging has been shown to play an important role in avoiding failure-to-rescue. We sought to examine the impact of the timing of such imaging studies on outcomes after pancreatectomy.
520			_aCONCLUSION: In our cohort, patients imaged early after pancreatectomy experienced shorter hospital stays and lower inpatient mortality relative to those scanned after the first postoperative week. Copyright © 2024 Elsevier Inc. All rights reserved.
520			_aMETHODS: Patients who underwent pancreatic resection at our institution from 2017 to 2022 were reviewed retrospectively to identify those undergoing computed tomography for any indication before discharge. Patients were subdivided by the postoperative day that the first computed tomography scan was obtained: immediate (postoperative day <3), early (postoperative day 3-7), and delayed (postoperative day >7).
520			_aRESULTS: Of 370 patients, 110 (30%) had a computed tomography during the initial surgical stay. The 3 timing groups were similar in age, comorbidities, pathology, operative time, and number of scans. When comparing the early with the delayed group, we found that antibiotic usage, percutaneous drainage, and overall invasive interventions during surgical stay were all similar. However, those patients who were scanned in the early period had significantly shorter length of stay (17.05 vs 22.82, P = .0008) and fewer composite days hospitalized (20.1 vs 24.9, P = .01) relative to the delayed group. Importantly, early computed tomography imaging was found to be the only independent predictor of a postoperative length of stay <=15 days on multivariate analysis. Surgical stay mortality rates were significantly lower in the early compared with delayed group (0% vs 11%, P = .02). A change in treatment was observed in 59% after computed tomography, with 15% undergoing invasive interventions, 27% treated medically, and 16% with expectant management.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Franklin Square Medical Center
656			_aMedStar General Surgery Residency
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aSurgery
657			_aJournal Article
700			_aNigam, Aradhya _bMGUH _cMedStar General Surgery Residency _dMD
700			_aShoucair, Sami _bMFSMC
790			_aBloomfield GC, Shoucair S, Nigam A, Park BU, Fishbein TM, Radkani P, Winslow ER
856			_uhttps://dx.doi.org/10.1016/j.surg.2024.06.051 _zhttps://dx.doi.org/10.1016/j.surg.2024.06.051
942			_cART _dArticle
999			_c14712 _d14712