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Practice Patterns of Pancreatic Surgery Within the Military.

Joy N Liang1, Andrew J Anklowitz1, Jonathan B Livezey1

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Pancreatic surgeries are decreasing in military facilities, with a few centers performing most procedures. Further research is needed to understand the impact on patient care and surgeon readiness.

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Area of Science:

  • Surgical Outcomes
  • Health Services Research
  • Military Medicine

Background:

  • Pancreatic surgery is complex with variable mortality rates.
  • High-volume centers and experienced surgeons are associated with better patient outcomes.
  • Limited data exists on pancreatic surgery volume within military treatment facilities (MTFs).

Purpose of the Study:

  • To evaluate the volume and types of pancreatic surgeries performed at MTFs.
  • To identify if a small number of MTFs perform the majority of these complex procedures.

Main Methods:

  • Retrospective review of de-identified data from the MHS Mart (M2) database (2014-2020).
  • Analysis of pancreatic procedure types and patient demographics across all Defense Health Agency facilities.
  • Primary endpoint: number and type of surgery per MTF.

Main Results:

  • Twenty-six MTFs performed pancreatic surgeries between 2014 and 2020.
  • A significant decrease in the overall number of pancreatic surgeries was observed during this period.
  • Distal pancreatectomy and pancreaticoduodenectomy were the most common procedures, both showing a decline in performance.

Conclusions:

  • Pancreatic surgery volume is low and declining in MTFs.
  • Further investigation is required to assess patient care, postoperative complications, and military surgeon readiness.