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Correspondence and Brief Communications |

Cost-Reduction Model for Treatment of Pancreatic Leak Following Distal Pancreatectomy—Reply

J. Ruben Rodriguez, MD; Carlos Fernandez-del Castillo, MD
Arch Surg. 2006;141(12):1267-1268. doi:10.1001/archsurg.141.12.1267-b.
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We appreciate the comments received regarding our article “Implications and Cost of Pancreatic Leak Following Distal Pancreatic Resection.” Unfortunately, we feel that there is some misunderstanding by the reader regarding the salient points, which we would like to help clarify. It is well known that distal pancreatic resections have a higher leak rate as compared with proximal pancreatectomy. A well-designed, prospective, multicenter trial, which applied accurate and sensitive definitions for PL, reported a rate of 34.5%.1 A recent meta-analysis attempting to recognize the superiority of one technical aspect of pancreatic stump closure over another failed to identify a “gold standard.”2 To highlight the importance of this underreported and (as of yet) unsolved problem3 we sought to objectify its repercussions by measuring hospital costs and demonstrating its increase in health care resource utilization.

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