Clinical and economic analysis of perioperative complication after pancreatectomy        SHI Chen-ye, XU Xue-feng, WANG Dan-song, et al. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Corresponding author：LOU Wen-hui，E-mail: wenhuilou@yahoo.com.cn
Abstract    Objective    To analyze the relationship of the pancreatic complications after pancreatectomy with in-hospital costs. Methods    The retrospective data were collected in a consecutive series of 341 patients undergoing pacreaticoduodenectomy or distal pancreatectomy from August 2005 to August 2009 in Department of General Surgery, Zhongshan Hospital of Fudan University. The incidence and severity of the perioperative complications including pancreatic fistula, bile fistula, bleeding, delayed gastric emptying (DGE) and so on were analyzed. Meanwhile, the relationship of the pancreatic complications after pancreatectomy with in-hospital costs was analyzed. Results    Among 341 patients, pancreatic fistula was observed in 156 patients (45.7%)；bile fistula was documented in 15 patients (4.4%)；delayed gastric emptying in 35 patients (10.3%)；bleeding in 17 patients (5.0%). The average in-hospital cost of the patients who did not develop pancreatic fistula was RMB 38 224 yuan, while the cost of those with grade C pancreatic fistula was RMB 103 293 yuan. The average in-hospital cost of the patients who did not develop bile fistula was RMB 38 758 yuan, while the cost of those with bile fistula was RMB 53 206 yuan. The average hospitalization cost of the patients who did not develop delayed gastric emptying (DGE) was RMB 37 992 yuan, while the cost of those with DGE was RMB 51 857 yuan. Both pancreatic fistula and DGE were closely related with in-hospital costs; the higher the grade, the more the in-hospital costs (P<0.05). Conclusion    The severity of the perioperative complication such as pancreatic fistula is the important reason of the high medical cost. Higher the grade, the longer the in-hospital stay and the more the medical cost.