Pancreatic Surgery

The pancreas is a solid organ that is positioned behind the stomach and is divided into three parts - the head, the body, and the tail. The head of the pancreas is connected to the main bile duct draining the liver and the duodenum, or the first part of the small intestine, and is positioned over several very important blood vessels supplying blood to the liver and the intestines. The tail of the pancreas abuts the spleen. The pancreas serves two important functions for the body, regulation of our blood sugar as well as assistance with digestion of the sugars and fats that we eat.Pancreas

Removal of part or all of the pancreas is performed for treatment of pancreatic cancer, pre-cancerous conditions of the pancreas like mucin producing cysts, or pancreatitis (inflammation of the pancreas). Removal of portions of the pancreas or the entire gland involves a very complex operation due to its relationship with other vital structures, and numerous studies have emphasized the importance of undergoing such surgery only at a high volume center by a high volume pancreatic surgeon.

The University of Michigan Health System multi-disciplinary pancreas program treats many patients each year with pancreatic disease. Surgeons, medical oncologists, radiation oncologists, gastroenterologists, pathologists, and radiologists who specialize in the care of patients with pancreatic disease work together to evaluate every patient, and to derive the best possible strategy for an individual patient's care. The following information focuses on surgical treatment, and the graphs demonstrate that UMHS has considerable experience in performing pancreatic surgery with excellent outcomes
when compared to peer institutions.

Procedure volume is the number of times a procedure was performed in a year. This measure is often used to assess experience and expertise of both the surgeon and the team caring for the patient. Studies have linked higher volumes with more successful outcomes for some types of procedures, including pancreatectomy. The following graphs compare the total number of major pancreatic operations performed at UMHS to the average number performed at 28 hospitals from the University Health System Consortium (UHC) that are similar to our own hospital.

Distal Pancreatectomy Case Volume

Details

Why is This Measure Important?

This is a measure of the volume, or number of distal pancreatic operations performed. Distal pancreatectomy refers to removing the tail and possibly body of the pancreas. It is important to consider both volume and outcome measures when assessing quality of care.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform a substantial and increasing number of complex pancreatic operations each year. Our surgeons have considerable experience and our program is growing.

UMHS Source: : University Health System Consortium (UHC)
Comparison Group Source:University Health System Consortium (UHC)

Proximal Pancreatectomy Case Volume

Details

Why is This Measure Important?

This is a measure of the volume, or number of proximal pancreatectomies or Whipple procedures performed. Proximal pancreatectomy or Whipple procedure involves removing the head and neck of the pancreas along with the common bile duct and the duodenum (first part of the small intestine). It is important to consider both volume and outcome measures when assessing quality of care.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform a substantial number of Whipple procedures each year. Our surgeons have considerable experience and our program is growing.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Total Pancreatectomy Case Volume

Details

Why is This Measure Important?

This is a measure of the volume, or number of total pancreatectomy operations performed. Total pancreatectomy combines distal and proximal pancreatectomies and means removing the entire pancreas. It is important to consider both volume and outcome measures when assessing quality of care.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform an increasing number of complex pancreatic operations each year. Our surgeons have considerable experience and our program is growing.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

In this Section we evaluate the quality of care for patients undergoing pancreatectomy by measuring mortality rates and the occurrence of complications after surgery. We measure the use of intensive care services after surgery and re-hospitalization rates as a means to estimate the occurrence of complications. The following graphs compare our performance to the average for 28 hospitals from the University Health System Consortium (UHC), that are similar to our own hospital.

In all of these graphs, a lower percentage means better performance. The graphs show that our complication and mortality rates are often lower than the average for the selected UHC hospitals.

Distal Pancreatectomy ICU Cases

Lower Value = Better Performance

Details

Why is This Measure Important?

Patients are admitted to an intensive care unit after surgery when they require a higher level of monitoring and care. A lower percentage of patients admitted to the intensive care unit after surgery indicates that patients were more stable and doing well, and had less risk of developing complications. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System had significantly lower intensive care admission rates than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Distal Pancreatectomy % Mortality (Observed)

Lower Value = Better Performance

Details

Why is This Measure Important?

Pancreatectomy is a relatively high risk operation. As with other outcome measures reported here, mortality after a pancreatectomy is often a reflection of how well the patient has been prepared for the operation, the skill of the surgeon, and the expertise of the team caring for the patient in the hospital. This is a measure of the percentage of patients who died after undergoing a pancreatectomy. For this measure, a lower percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System,distal pancreatectomy patients fare better than the averages for 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Distal Pancreatectomy 14 Day Re-Admission Rate

Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the percentage of patients who were discharged from our hospital following pancreatectomy and were then re-hospitalized (readmitted) within 14 days. This measure evaluates the quality of care during the first hospitalization. A necessary return to the hospital after a patient has been discharged is an indicator that all problems may have not been identified or resolved before the patient was discharged home after a surgery. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System typically has lower readmission rates for patients undergoing distal pancreatectomies than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Distal Pancreatectomy Average Length of Stay

Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the average time in days a patient is in the hospital when having this procedure. For this measure, a lower average length of stay combined with a lower rate of re-hospitalization (Re-admission) means better and more efficient performance.

How is UMHS Performing?

The University of Michigan Health System typically has shorter lengths of stay on average for patients undergoing distal pancreatectomy than the average at 28 similar hospitals which are members of the University Health System Consortium.

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UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Proximal Pancreatectomy ICU Cases
Lower Value = Better Performance

Details

Why is This Measure Important?

Patients are admitted to an intensive care unit after surgery when they require a higher level of monitoring and care. A lower percentage of patients admitted to the intensive care unit after surgery indicates that patients were more stable and doing well, and had less risk of developing complications. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System had significantly lower intensive care admission rates than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Proximal Pancreatectomy % Mortality (Observed)
Lower Value = Better Performance

Details

Why is This Measure Important?

Proximal pancreatectomy (Whipple) is a high risk operation. As with other outcome measures reported here, mortality after a pancreatectomy is often a reflection of how well the patient has been prepared for the operation, the underlying medical condition of the patient, the impact of other cancer therapies before surgery, the skill of the surgeon, and the expertise of the team caring for the patient in the hospital. This is a measure of the percentage of patients who died after undergoing a proximal pancreatectomy.

How is UMHS Performing?

At the University of Michigan Health System, proximal pancreatectomy patients have a similar mortality rate compared to the averages for 28 similar hospitals which are members of the University Health System Consortium. The University of Michigan Pancreas program has demonstrated a consistent low mortality rate of 1-2% following proximal pancreatectomy despite performing these operations on patients with increasingly advanced disease and requiring vascular reconstruction (repairing the blood supply vessels)  performed at the time of Whipple procedure.  As we continuously monitor and strive to improve our quality and outcomes we hope to bring this mortality rate to <1% in the near future even in this complex patient population.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Proximal Pancreatectomy 14 Day Re-Admission Rate

Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the percentage of patients who were discharged from our hospital following pancreatectomy and were then re-hospitalized (readmitted) within 14 days. This measure evaluates the quality of care during the first hospitalization. A necessary return to the hospital after a patient has been discharged is an indicator that all problems may have not been identified or resolved before the patient was discharged home after a surgery. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System overall has equivalent readmission rates for patients undergoing proximal pancreatectomies as compared to the average at 28 similar hospitals which are members of the University Health System Consortium. We are continuously evaluating the root cause of readmissions to provide the best care and follow through for our patients.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Proximal Pancreatectomy Average Length of Stay

Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the average time in days a patient is in the hospital when having this procedure. For this measure, a lower average length of stay combined with a lower rate of re-hospitalization (Re-admission) means better and more efficient performance.

How is UMHS Performing?

The University of Michigan Health System consistently has shorter lengths of stay on average for patients undergoing proximal pancreatectomy (Whipple Procedures) than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Total Pancreatectomy ICU Cases
Lower Value = Better Performance

Details

Why is This Measure Important?

Patients are admitted to an intensive care unit after surgery when they require a higher level of monitoring and care. A lower percentage of patients admitted to the intensive care unit after surgery indicates that patients were more stable and doing well, and had less risk of developing complications. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System had lower intensive care admission rates than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Total Pancreatectomy % Mortality (Observed)
Lower Value = Better Performance

Details

Why is This Measure Important?

Pancreatectomy is a relatively high risk operation. As with other outcome measures reported here, mortality after a pancreatectomy is often a reflection of how well the patient has been prepared for the operation, the skill of the surgeon, and the expertise of the team caring for the patient in the hospital. This is a measure of the percentage of patients who died after undergoing a pancreatectomy. For this measure, a lower percentage means better performance.

How is UMHS Performing?

At the University of Michigan Health System, total pancreatectomy patients fare better than the averages for 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Total Pancreatectomy 14 Day Re-Admission Rate
Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the percentage of patients who were discharged from our hospital following pancreatectomy and were then re-hospitalized (readmitted) within 14 days. This measure evaluates the quality of care during the first hospitalization. A necessary return to the hospital after a patient has been discharged is an indicator that all problems may have not been identified or resolved before the patient was discharged home after a surgery. For this measure, a lower percentage means better performance.

How is UMHS Performing?

The University of Michigan Health System typically has lower readmission rates for patients undergoing total pancreatectomies than the average at 28 similar hospitals which are members of the University Health System Consortium. We are continuously evaluating the root cause of readmissions to provide the best care and follow through for our patients.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)

Total Pancreatectomy Average Length of Stay

Lower Value = Better Performance

Details

Why is This Measure Important?

This measure is defined as the average time in days a patient is in the hospital when having this procedure. For this measure, a lower average length of stay combined with a lower rate of re-hospitalization (Re-admission) means better and more efficient performance.

How is UMHS Performing?

The University of Michigan Health System typically has shorter lengths of stay on average for patients undergoing total pancreatectomy than the average at 28 similar hospitals which are members of the University Health System Consortium.

UMHS Source: University Health System Consortium (UHC)
Comparison Group Source: University Health System Consortium (UHC)