Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2022; 14(5): 419-428
Published online May 27, 2022. doi: 10.4240/wjgs.v14.i5.419
Effect of overtime pancreaticoduodenectomy on the short-term prognosis of patients
Jin-Zhu Zhang, Shu Li, Wei-Hua Zhu, Xi-Sheng Leng, Da-Fang Zhang
Jin-Zhu Zhang, Shu Li, Wei-Hua Zhu, Xi-Sheng Leng, Da-Fang Zhang, Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China
Author contributions: Zhang JZ designed the study, acquired and analyzed the data, and wrote the paper; Li S acquired and analyzed the data, and revised the paper; Zhu WH acquired and analyzed the data, and revised the paper; Leng XS revised the paper; Zhang DF designed the study, revised the paper, and supervised the study.
Supported by Peking University People’s Hospital Scientific Research Development Funds, No. RDY2017-28.
Institutional review board statement: The study was reviewed and approved by the Peking University People’s Hospital Institutional Review Board (Approval No. 2021PHB050-001).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict-of-interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Fang Zhang, MD, PhD, Assistant Professor, Assistant Statistician, Department of Hepatobiliary Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. byronzdf@sina.com
Received: December 26, 2021
Peer-review started: December 26, 2021
First decision: March 10, 2022
Revised: March 23, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: May 27, 2022
Abstract
BACKGROUND

Due to the large number of operations, surgeons sometimes need to work overtime or even stay up late to perform pancreaticoduodenectomy. Fatigue and sleep deprivation can result in an increased error rate at work. There have been numerous studies about the effect of overtime surgery on the prognosis of patients. However, the effect of overtime work for pancreaticoduodenectomy on the prognosis of patients is unclear. This study explores the impact of overtime work for pancreaticoduodenectomy on the prognosis of patients.

AIM

To explore the impact of overtime work for pancreaticoduodenectomy on the short-term prognosis of patients.

METHODS

This was a single-center, retrospective cohort study. The patients who underwent pancreaticoduodenectomy between January 2017 and December 2019 were included. Patients were stratified by operative start time into the control group (surgery that started between 8:00 and 16:49) and the overtime group (surgery that started between 17:00 and 22:00) and compared intraoperative and postoperative parameters. The following parameters were compared between the overtime group and the control group: Operative time, blood loss, number of lymph nodes removed, duration of treatment in the Intensive Care Unit (ICU), and incidence of complications.

RESULTS

From January 2017 to December 2019, a total of 239 patients underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of our institution. Four patients were excluded from this study due to lack of clinical data. A total of 235 patients were included, with 177 in the control group and 58 in the overtime group. There was no difference between the two groups in operative time, blood loss, number of lymph nodes removed, ICU length of stay, hospital length of stay, mortality during hospitalization. Compared with the control group, the overtime group had a higher incidence of pancreatic fistula (32.8% vs 15.8%, P < 0.05). Multivariate analysis showed that overtime work, higher Body Mass Index were independent risk factors for pancreatic fistula (P < 0.05).

CONCLUSION

Overtime work for pancreaticoduodenectomy increases the incidence of pancreatic fistula. The effect of overtime surgery on the long-term prognosis of patients’ needs to be further studied.

Keywords: Pancreaticoduodenectomy, Fatigue, Surgery, Pancreatic fistula, General surgery, Overtime surgery

Core Tip: The effect of overtime work for pancreaticoduodenectomy on the prognosis of patients is unclear. We explore the impact of overtime work for pancreaticoduodenectomy on the prognosis of patients. A total of 235 patients were included, with 177 in the control group and 58 in the overtime group. Overtime work for pancreaticoduodenectomy increases the incidence of pancreatic fistula. The effect of overtime surgery on the long-term prognosis of patients’ needs to be further studied.