• Patrick L Quinn, Melica Nikahd, Shah Saiyed, Addie Heifetz, Natalie M Bath, J Madison Hyer, Jordan M Cloyd, Shikha Jain, and Aslam Ejaz.
• The Ohio State University Wexner Medical Center, Columbus, OH.
• J. Am. Coll. Surg. 2024 Sep 19.

BackgroundDue to the complexity of pancreatic surgery, patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) may seek out the opinion of more than one surgeon. Little is known regarding how second surgical opinions impact the likelihood of pancreatectomy and perioperative outcomes. Our study aimed to determine the impact of obtaining second surgical opinions on pancreatectomy rates and to assess its impact on surgical outcomes.Study DesignPatients who were diagnosed with PDAC between 2013 and 2020 were identified using 100% Medicare Inpatient and Outpatient Standard Analytic Files (SAFs). Data collected included the number of surgeons consulted and geographic region. Receipt of pancreatectomy and perioperative outcomes were compared between patients who received more than one surgical consultation.ResultsOf 116,072 patients diagnosed with PDAC, 10,640 (9.2%) underwent pancreatectomy. Among the 1,906 (17.9%) patients who underwent pancreatectomy after a second opinion, 39.7% (n=756) underwent resection with their initial surgeon. Patients receiving a second surgical opinion were more likely to undergo pancreatectomy (adjusted odds ratio [aOR] 6.17; 95% CI 5.78-6.59), with decreased odds among rural patients (aOR 5.57; 95% CI: 4.64-6.69). Patients who underwent surgery and received a second opinion had equivalent length of stay and complication rates compared to those who did not seek a second opinion (both p>0.05).ConclusionsAmong Medicare patients who underwent pancreatectomy for pancreatic cancer, approximately 1 in 7 patients received a second surgical opinion. Additional research is needed on the impact of second opinions on long-term cancer-specific outcomes.Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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