{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:54:08Z","timestamp":1791266048406,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The optimal timing of hospital discharge after pancreatoduodenectomy remains challenging because objective discharge criteria have not been well established. We aimed to evaluate the clinical validity of our institutional discharge criteria and identify risk factors for unplanned readmission.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single\u2010center retrospective study included consecutive patients who underwent pancreatoduodenectomy at our institution between 2007 and 2024. Patients with in\u2010hospital mortality were excluded. Institutional recommended discharge criteria consisted of independent activities of daily living, adequate oral intake, and a declining serum C\u2010reactive protein (CRP) level <\u20095.0\u2009mg\/dL. The primary outcome was the 30\u2010day unplanned readmission rate. Multivariable logistic regression analysis identified risk factors for readmission.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 976 patients, the median postoperative length of stay was 13\u2009days and the 30\u2010day readmission rate was 9.8% (\n n<\/jats:italic>\n \u2009=\u200996). Multivariable analysis showed that postoperative intra\u2010abdominal abscess (odds ratio [OR], 2.82) and serum CRP level \u2265\u20095.0\u2009mg\/dL at discharge (OR, 3.34) were associated with higher risk of readmission. Patients who fulfilled the discharge criteria consistently showed lower readmission rates regardless of postoperative length of stay.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our objective discharge criteria showed clinical validity, ensuring safe discharge after pancreatoduodenectomy. Patients with postoperative intra\u2010abdominal abscesses may require stricter discharge assessment to reduce the risk of readmission.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jhbp.70196","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:19:53Z","timestamp":1791263993000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Discharge Criteria and Risk Factors for Readmission After Pancreatoduodenectomy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2276-8637","authenticated-orcid":false,"given":"Takahisa","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"},{"name":"Department of Surgery Southern Tohoku General Hospital Koriyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"},{"name":"Department of Hepatobiliary and Pancreatic Surgery Institute of Science Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7880-889X","authenticated-orcid":false,"given":"Daisuke","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Mii","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7062-817X","authenticated-orcid":false,"given":"Hidetaka","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So","family":"Yamaki","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6527-5409","authenticated-orcid":false,"given":"Sohei","family":"Satoi","sequence":"additional","affiliation":[{"name":"Department of Pancreatobiliary Surgery Kansai Medical University Hirakata Japan"},{"name":"Division of Surgical Oncology, Department of Surgery University of Colorado Anschutz Medical Campus Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.hpb.2020.07.013","article-title":"The Improvement in Post\u2010Operative Mortality Following Pancreaticoduodenectomy Between 2006 and 2016 Is Associated With an Improvement in the Ability to Rescue Patients After Major Morbidity, Not in the Rate of Major Morbidity","volume":"23","author":"Pastrana Del Valle J.","year":"2021","journal-title":"HPB"},{"issue":"6","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1111\/ans.17473","article-title":"Procedure\u2010Specific Morbidity of Pancreatoduodenectomy: A Systematic Review of Incidence and Risk Factors","volume":"92","author":"Russell T. 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