815 - other international versions of ICD-10 Z48. There is a multitude of surgical techniques for both benign and malignant processes of the pancreas, including different types of surgical excision. 41) Z90. Access to this feature is available in the following products: Find-A-Code Essentials. This was the first year ICD-10-CM was implemented into the HIPAA code set. 9, 80, D13. Methods: This study was designed to analyze perioperative risk factors for POPF after PD and evaluate the factors that predict the extent and severity of leak. 94 Endoscopic removal of stone (s) from. The ICD-10 Procedure Coding System (ICD-10-PCS) is a system of medical classification used for procedural codes. The aim of this paper is to offer a state-of-the-art review on. Due to the shared blood supply of organs in the proximal gastrointestinal. B15. In 10 patients, a pancreatogastrostomy was performed; all of the remaining patients underwent a pancreatojejunostomy. ICD-10-PCS before its release in 1998. Applicable To. 8 for Other ascites is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified . 1 - other international versions of ICD-10 D33. Methods: From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled. It involves a side-to-side anastomosis of the pancreatic duct and the jejunum. Induction therapy: The first treatment for the. The 2024 edition of ICD-10-CM K68. K91. An intraductal papillary mucinous neoplasm (IPMN) is a benign pancreatic cyst in the ducts of your pancreas that can become malignant, or cancerous. Owing to the complexity of this procedure, pitfalls that lead to major complications can occur. Baseline Characteristics. Symptoms are inconsistent but postprandial abdominal pain, recurrent acute pancreatitis, and impaired pancreatic function are the most frequent. 96. Pancreatoduodenectomy for adenocarcinoma in the head of pancreas can provide long-term survival in a subset of patients, particularly in the absence of lymph node metastasis. Consequently, it is vital to discern a postoperative prognostic biomarker. Whipple’s disease is number 81. The 2024 edition of ICD-10-CM L92. Previous studies conflict on the net benefit of TP. This is the American ICD-10-CM version of E08 - other international versions of ICD-10 E08 may differ. Application of procedure code 54. The aim of this meta-analysis was to evaluate whether robotic pancreaticoduodenectomy (PD) may provide better clinical and pathologic outcomes compared to its open counterpart. Specialty: Gastroenterology,. The outcomes and complications of pancreaticoduodenectomy (Whipple procedure): Cross sectional study. ICD-10-CM Code for Other ascites R18. 1 - other international versions of ICD-10 K68. Methods/design: This is a randomized controlled. 7), or total pancreatectomy. Pancreaticoduodenectomy, so‐called “Whipple operation,” is a time‐consuming and technically demanding complex operation. 1 | Page PMB definition guideline for Early Stage Pancreatic Cancer PMB definition guideline for early stage pancreatic cancer . Outcomes of our surgical team compared to the published data of some other centers. 2/7/9, or E34. 0 by an endocrinologist. Match case Limit results 1 per page. Over the past decade, performance of the Whipple procedure, or pancreatoduodenectomy, to treat both malignant and benign disease has increased. Whipple’s procedure. Compared with PD, enucleation for IPMN has less blood loss, shorter operative time and similar morbidity, mortality, hospital length of stay (LOS) and readmission rate. Neoadjuvant Therapy* / methods. 5 cm in diameter. This is the American ICD-10-CM version of Z85. 1 This is particularly true for high-volume centres. doi: 10. The 2024 edition of ICD-10-CM Z90. Understanding the potential complications and recognizing them are imperative to ta. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 815 may differ. Background: We compared outcomes of neoadjuvant therapy delivered as chemotherapy-only (Chemo) versus concurrent chemoradiation (ChemoRT) versus chemotherapy followed by radiation (Chemo-ChemoRT) among pancreatic head adenocarcinoma patients receiving pancreaticoduodenectomy. Codes used to report surgeries for tumor excision in people with pancreatic cancer include: Distal Pancreatectomy – During this surgery, the left side of the pancreas is removed. 1 (Postprocedural hypoinsulinemia). It is the most common pancreatic resection performed, especially in the setting of pancreatic malignancy. It is usually performed to treat malignancies on the head of the pancreas, common bile duct, or duodenum (which are near the pancreas) but also may be performed in abdominal trauma cases involving the pancreas and duodenum. Islet AutoTransplantation (“IAT”) - After the pancreas has been. The primary surgical procedure remains laparoscopic: You should not report unlisted procedure codes or. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Applicable To. XXXA may differ. The Clinical Classifications Software (CCS) for ICD-10-PCS (beta version) is a procedure categorization scheme that can be employed in many types of projects analyzing data on procedures. 1. The observation period was set at 1 to 12 months after partial pancreatectomy to exclude the period of unstable glucose metabolism immediately after surgery, [ 16 ] and based on previous studies suggesting. The only potentially curative treatment for ampullary carcinoma is surgical resection. On univariate analysis, hypertension, PpPD, operation time, intraoperative bleeding, packed red blood cell transfusion ≥500 mL, and clinically. With ICD-9, the Whipple was coded as Radical Pancreaticoduodenectomy, better known as a 52. Pancreaticoduodenectomy is a classic surgical procedure for the treatment of benign and malignant tumors around the head of the pancreas, the lower common bile duct, the duodenum, and the ampulla (). 01. 3 - other international versions of ICD-10 Z48. This is the American ICD-10-CM version of C22. The 2024 edition of ICD-10-CM Z90. This is the American ICD-10-CM version of E89. 0: Malignant neoplasm of duodenum: C22. 7 MeSH: D016577 Other codes: A pancreaticoduodenectomy, Whipple procedure, or Kausch-Whipple procedure, is a major surgical operation involving the pancreas, duodenum, and other organs. Pancreaticoduodenectomy (PD) is the commonest procedure performed for pancreatic cancer. 855-695-4872 Outside of Maryland. Outcomes of our surgical team compared to the published data of some other centers. HPB (Oxford)2011 Jun;13 (6):377-84. This is the American ICD-10-CM version of L92. This complex procedure is associated with a high morbidity rate. 3 may differ. The 2024 edition of ICD-10-CM C25. Laparoscopic pancreaticoduodenectomy (LPD) was first reported by Gagner and Pomp in 1994 (). 001) (Fig. Traditional techniques for performing pancreaticoduodenectomy have emphasized the importance of establishing a tumor-free plane between the SMPV confluence and the neck of the pancreas. 09 may differ. In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. K83. ijsu. Adenocarcinoma / mortality*. 0 Malignant neoplasm, head of pancreas. Although surgical resection remains the only chance for long-term patient survival, the likelihood of initial resectability is no higher than 20%. 0 may differ. Postpancreatectomy hemorrhage (PPH) and intra-abdominal abscess (IAA) are the most severe POPF-related complications, and. International Classification of Diseases 9th Revision: 527. Pancreaticoduodenectomy (PD) is a mainstay in the management of periampullary tumors. One patient with a high-grade malignant neoplasm died after 15. liver cirrhosis (ICD-9 571. Not all of these tumors become cancer. 59 Other partial pancreatectomy convert 52. The laparoscopic technique of resection and reconstruction with a gastrojejunostomy, hepaticojejunostomy, and pancreaticojejunostomy is described. 59 were considered pancreatic head resections. 819 ICD-10 code D72. Methods: PubMed, EMBASE, Science Citation. 59), pancreaticoduodenectomy (ICD-9 codes 52. This study aimed to develop a nomogram to identify potential predictors and predict the probability of DGE after PD. The 2024 edition of ICD-10-CM Z48. 9: Malignant neoplasm of pancreas: C7A. 410 [convert to ICD-9-CM] Acquired total absence of pancreas. 1], and duodenal cancer [ICD-9 152. . This is the American ICD-10-CM version of Z85. Z90. 92 Cannulation of pancreatic duct convert 52. View in full-text. 5), hypertension (ICD-9 401–405), and peptic ulcer diseases (ICD-9 531–535). 9 - other international versions of ICD-10 B15. Core tip: Stricture of pancraticojejunostomy is a late and potentially serious complication after pancreaticoduodenectomy. Total laparoscopic pancreaticoduodenectomy (tLPD) for cancer of the Vater remains a challenging procedure. jamcollsurg. An ICD-10-PCS definition of pancreaticoduodenectomy using codes for (1) open or percutaneous endoscopic excision or resection of the pancreas and (2) similar. 22, 52. Complete tumor resection with negative margins (R0 resection) is a prerequisite for cure. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. For patients with at least. Logistic regression models were constructed using the 2014. The 2020 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2020. Pancreaticoduodenal artery aneurysms are rare and account for 2% of all visceral aneurysms. 410 became effective on. Background: Pancreatoduodenectomy may lead to new-onset diabetes mellitus, also known as type 3c diabetes, but the exact risk of this complication is unknown. Request a Demo 14 Day Free Trial Buy Now. We divided the pancreas. 0 Malignant neoplasm of head of pancreas E89. 520 became effective on October 1, 2023. (69%) had one or more lymph nodes with metastatic involvement; 10 of these had disease in CHALN. This is the American ICD-10-CM version of B15. In addition to pancreatectomy, systemic therapy is used across all disease stages because it is associated with improved survival, and radiotherapy is utilized in select patients with the goal of improving local disease control. Using a propensity score model to adjust for potentially confounding. Radical pancreaticoduodenectomy ICD-9-CM Vol 3 Code 52. Pancreatic ductal adenocarcinoma (PDAC) is a leading causes of cancer mortality worldwide. 9 became effective on October 1, 2023. 41) Z90. Free, official information about 2012 (and also 2013-2015) ICD-9-CM diagnosis code V58. These are referred to as pylorus-removing. Patients who underwent pancreaticoduodenectomy were identified using the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) proce-dure code 52. 0 Malignant neoplasm, head of pancreas. releasing yearly updates. Minimally invasive pancreaticoduodenectomy (MI-PD) was first described in the mid-1990s, initially performed as a laparoscopic procedure by separate groups from Canada, Scotland, and Japan. Abstract. The incidence of major morbidity did not differ statistically among these three diagnoses ( P = 0. 0 became effective on October 1, 2023. We report a case of pancreatic head cancer with CTPV in a. Pancreaticoduodenectomy, also referred to as the “Whipple” or “Kausch-Whipple” procedure, is the most common surgical procedure for the resection of tumors in the pancreatic head, uncinate process, and neck as well as lesions of the ampulla, extrahepatic bile duct, and duodenum []. 86 Transplantation of cells of Islets of Langerhans, not otherwise specified convert 52. 3% without major complications. 80 Pancreatic transplant, not otherwise specified convert 52. 07 - other international versions of ICD-10 Z85. Recently, several meta-analyses showed the superior aspects of “superior mesenteric artery (SMA)-first approach,” “systematic mesopancreas dissection,” and “circumferential lymphadenectomy around SMA” in. The patient undergoes neoadjuvant chemoradiation and a. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. We found that robotic PD had lower 30-day (4. This is the American ICD-10-CM version of Z48. In this single institution study, 30-d mortality after pancreaticoduodenectomy is 1. % of Total ICD 527 - Radical Pancreaticoduodenectomy in DRG: 0. Answer: For encounters with your surgeon following the Whipple procedure, you’ll need to code the cancer as C25. 7. Pancreaticoduodenectomy (PD) is the main therapy for resectable and borderline resectable pancreatic ductal adenocarcinoma (PDAC) []. 1 may differ. MethodsPubMed, Web. The aim of the study was to compare histological features, postoperative outcomes, and long-term prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma. An ICD-10-PCS definition of pancreaticoduodenectomy using codes for (1) open or percutaneous endoscopic excision or resection of the pancreas and (2) similar codes for the duodenum, consistent with coding guidelines, has satisfactory test characteristics. 92 to ICD-10-PCS. Postoperative pancreatic fistula is still the most dangerous complication of laparoscopic pancreaticoduodenectomy. Robotic surgery is covered by routine and customary laparoscopic CPT® and ICD-9-CM coding practices, existing medical policies for advanced laparoscopic surgery, and current payer contract rates. This is the American ICD-10-CM version of Z85. The classic Whipple procedure (involving removal. 8, and C25. Anthem is the only carrier that states that it is included in the whipple but. View 213 Download 0 Facebook. 6), and distal pancreatectomy (ICD-9-CM procedure codes: 52. Of course it would help to see a copy f the note, but you cannot use an open procedure code for a laparoscopic procedure. Laparoscopic surgery reduces surgical morbidity in various operations, however laparoscopic pancreaticoduodenectomy (LPD) is a relatively new procedure which lacks a clear consensus regarding its benefits (10-14). Pancreaticoduodenectomy / mortality. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation. The most common complications after a pancreaticoduodenectomy are delayed gastric emptying, pancreatic fistulae, hemorrhage, chyle leaks, endocrine and exocrine pancreatic insufficiency, and surgical site infections. Purpose: This study was conducted to assess the prevalence and significance of "haziness" around the hepatic artery and celiac axis in patients after pancreaticoduodenectomy. 13,504. Neoadjuvant therapy: chemotherapy delivered before surgical resection of the primary tumour, designed to enable earlier treatment of micrometastases. The ICD-9 procedure code 57. 7. K74. Robotic pancreaticoduodenectomy has generated signicant interest in recent years. 4. (ICD-O3) were used to identify duodenal, distal bile duct, ampulla of Vater and pancreatic cancers, using site codes C170, C240, C241, and C250-4 and C257-9. ). Other codes: A pancreaticoduodenectomy, Whipple procedure, or Kausch-Whipple procedure, is a major surgical operation involving the pancreas, duodenum, and other organs. Use Additional. Match case Limit results 1 per page. 8 may differ. Nationwide mortality rates after PD decreased from 9·8 to 5·1 per cent (P = 0·044). Synonyms: h/o: major abdominal surgery, history of excision of intestinal. Evidence level: ModeratePancreatectomy. 641 became effective on October 1, 2017. 410 became effective on October 1, 2023. ICD-9-CM. noted significant improvement in outcomes associated with pancreaticoduodenectomy when performed at a center with increased volume 10. 8 - other international versions of ICD-10 L92. AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS - 2019 Issue 1 Whipple Procedure. Radical Pancreaticoduodenectomy. 0%–1. 6 to ICD-10-PCS; 52. Z90. Although surgical resection remains the only chance for long-term patient survival, the likelihood of initial resectability is no higher than 20%. Although, it is commonly a one-stage procedure, damage control surgery corroborates with a two-stage PD performed on unstable trauma victims. 6 months after surgery. 3 became effective on October 1, 2023. , a Whipple procedure) may be performed for patients with an inflammatory mass in the head of the pancreas. Background. Applicable To. 52. 41 became effective on October 1, 2023. The 2024 edition of ICD-10-CM L92. Gastric outlet obstruction (GOO) is a clinical syndrome that can manifest with a variety of symptoms, including abdominal pain, postprandial vomiting, early satiety, and weight loss. The 2024 edition of ICD-10-CM Z48. 1], and duodenal cancer [ICD-9 152. Pancreaticoduodenectomy (PD) is a highly complex procedure that requires considerable expertise. 52. 7 - Radical pancreaticoduodenectomy. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. This is likely in part due to the. A surgeon must not only understand precise surgical techniques but also have a good comprehension of pancreatic anatomy,. It is usually only carried. In about 20% of patients undergoing pancreaticoduodenectomy to treat chronic pancreatitis, groove pancreatitis is detected. Between 1974 and 1995, 75 patients with pancreatic head carcinoma underwent pancreaticoduodenectomy in our department. Conclusion: An ICD-10-PCS definition of pancreaticoduodenectomy using codes for (1) open or percutaneous endoscopic excision or resection of the pancreas and (2) similar codes for the duodenum, consistent with coding guidelines, has satisfactory test characteristics. 1007/BF00642443. A pancreaticoduodenectomy, pancreatoduodenectomy, [1] Whipple procedure, or Kausch-Whipple procedure is a major surgical operation most often performed to remove cancerous tumours off the head of the pancreas. 107-112 CHINESE MEDICAL SCIENCES JOURNAL ORIGINAL ARTICLE Standard Versus Extended Pancreaticoduodenectomy in Treating Adenocarcinoma…Efficacy and outcomes of resection for pancreatic neuroendocrine tumors (pNET) are well established; specific data on outcomes for pancreaticoduodenectomy (PD), either alone or with combined procedures, are limited. This is the American ICD-10-CM version of W08. 10. 9 may differ. However, in ICD-10-PCS each component of the procedure is reported with a separate code. Trauma pancreaticoduodenectomy (TP) remains a challenging operation with morbidity and mortality rates as high as 80% and 50%. Pancreaticoduodenectomy (PD) holds high postoperative morbidity. 3% (n=863) and occurred at a median of 3. The head of the pancreas lies in the duodenal C loop in front of the inferior vena cava (IVC) and the left renal vein (see the images below). Only a few reports have described surgical difficulties in patients with CTPV. This improvement may partly be attributed to the establishment of specialized centres that perform large numbers of pancreatic resections 12, although morbidity rates remain high (38–44 per cent) in experienced centres 1–4, 11, 13–19. Pancreaticoduodenectomy in Florida: do 20-year. 3 may differ. 7, 52. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Applicable To. ICD-9 Code Type: Procedure. Laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic outcomes and long-term survival. ICD-10-CM Z90 will be released in 2021. This is the American ICD-10-CM version of D33. Background: Studies of pancreaticoduodenectomy (PD) frequently overlook diagnosis as a variable when evaluating postoperative outcomes or generically group patients according to whether they have 'benign' or 'malignant' disease. 2018 Apr;52:383-387. Early national experience with laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma: a comparison of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy from the National Cancer Data Base. Subscribe to Codify by AAPC and get the code details in a flash. Number of ICD-10-AM 7th edition. Neoadjuvant treatment (NAT) plays a major role in the t. The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. 07 may differ. Pancreaticoduodenectomy (PD) is routinely performed for resection of neoplasms of pancreatic head and uncinate process. Its treatment is via pancreaticoduodenectomy (Whipple's procedure). XXXA describes the circumstance. Background: Resection margin status is an important prognostic factor in pancreatic cancer; however, the impact of positive resection margins in those who received neoadjuvant therapy remains unclear. Enucleations were associated with shorter operation time, less blood loss as well as shorter ICU and hospital stay compared to pancreaticoduodenectomy and left resections. Adenocarcinoma / pathology. For a surgical procedure that is extremely complex, the history behind it is no less worthwhile. This is the American ICD-10-CM version of Z90. able to insert a 2-0 Prolene stitch at the inferior border of the pancreas. CASE REPORT Pancreaticoduodenectomy for pancreas carcinoma occurring in the annular pancreas: report of a case Hiromichi Kawaida1 • Hiroshi Kono1 • Mitsuaki Watanabe1…The pancreaticoduodenectomy (Whipple procedure) is a complex operation with the potential for significant morbidity and mortality. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS)Pancreatic cancer is the fourth leading cause of cancer deaths, being responsible for 7% of all cancer-related deaths in both men and women. This is the American ICD-10-CM version of K74. · ICD 10 code WHO description C25. at the distal body just proximal to the position of the cyst seen on. 3 may differ. 49 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. We identified patients undergoing pancreaticoduodenectomy using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 52. For patients with at least a 3-year follow-up. Use Additional. 0000000000002600. Pancreatic ductal adenocarcinoma (PDAC) is the most common malignancy of the pancreas. 51, 52. were classified as having periampullary adenocarcinoma. 8 months, the incidence of P-DM was 20. 1%). 10. 31 may differ. Use Additional. 3 In. The primary outcome was the development of postoperative P-DM after surgery. We modified Blumgart pancreaticojejunostomy and applied the. 3 Procedure Codes. Objective: To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. 0 became effective on October 1, 2023. 21, 863. 52. 3 - other international versions of ICD-10 L92. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 53 and 52. 01. 8 ICD-10 code R18. Understanding the potential complications and recognizing them are imperative to ta. #2. Background Radical pancreaticoduodenectomy is the most common treatment strategy for patients diagnosed with adenocarcinoma of the pancreatic head. Increased experience has led to a decline in mortality rate after pancreatoduodenectomy over the past decade 1–11. Epub 2018 Mar 20. jss. Twitter. B15. Since then, more and more centers started carrying out this procedure not only in pancreatic cancer or periampullary malignancies, but also in benign disease or low-grade malignant neoplasm (2-5). 1016/j. The provider documented Whipple pyloric sparing pancreaticoduodenectomy, pancreaticojejunostomy and hepaticojejunostomy. of 14 /14. The pancreatoduodenectomy, also known as the Whipple procedure, is the surgical procedure of choice for the resectable and the borderline resectable pancreatic ductal adenocarcinomas. 7), total pancreatectomy (ICD-9-CM procedure code: 52. 8 contain annotation back-references Background Delayed gastric emptying (DGE) remains one of the major complications after pancreaticoduodenectomy (PD), with discrepant reports of its contributing factors. Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anatomy poses a major challenge to gastrointestinal endoscopists. 52. Conventional pancreaticoduodenectomy involves a distal gastrectomy with removal of the pancreatic head, duodenum, first 15 cm of the jejunum, common bile duct,. Subscribe to Codify by AAPC and get the code details in a flash. The death rate after pancreaticoduodenectomy in the Netherlands was 12. 3 became effective on October 1, 2023. At the time of diagnosis, only about 20% of patients with pancreatic ductal adenocarcinoma (PDAC) have resectable disease. Methods: National Cancer Data Base cases diagnosed. D010193. 3% vs 4. 1 became effective on October 1, 2023. D33. #2. The 2024 edition of ICD-10-CM B15. doi: 10. A Whipple by any other name would take the same code (s) — and those names might include pancreaticoduodenectomy, pancreatoduodenectomy,. 41 became effective on October 1, 2023. ) Superior pancreaticoduodenal is at #11. doi: 10. 7, Radical pancreaticoduodenectomy (Whipple procedure) is reported as one operative session where numerous surgical components are performed. Herein we present a case of a large post-pancreaticoduodenectomy SMA pseudoaneurysm that required thrombin injection after initial stent-graft deployment to accomplish complete pseudoaneurysm occlusion. #1. 78). Large multicentre studies comparing postoperative outcomes in PD stratified by diagnosis are lacking. The outcomes and complications of pancreaticoduodenectomy (Whipple procedure): Cross sectional study. " Although first performed by the German surgeon Kausch in 1909, the operation was popularized by Dr. As the population ages, pressure to offer surgical therapy to elderly patients will increase. [1,2,3,4,5] This procedure is usually done via classic or pyloric preservation that stomach antrum is usually resected. 1097/SLA. 52. Indications for su rgery included pancreatic head tumor (n = 18), ampullary carcinoma (n =8), bile duct carcinoma (n = 22), gallbladder carcinoma (n = 2), and trauma (n = 1). The Pubmed, EMBASE. 4% and no risk factor is identified. Acquired absence of organs, not elsewhere classified (Z90) Acquired absence of pancreas (Z90. However, the perioperative outcomes of LPD versus OPD are still controversial. 0: Malignant neoplasm of extrahepatic bile duct: C24.