The Utility of 24/7 Interventional Radiology Service Post-Pancreaticoduodenectomy IR post-pancreatectomy

Background: We investigated the utility and outcomes of interventional radiology procedures in post-pancreaticoduodenectomy patients at a high-volume tertiary centre with 24/7 access to an interventional radiology service. Methods: Retrospective review of all patients who underwent pancreaticoduodenectomy between January 2019 and December 2023 and analysis performed on patients who underwent interventional radiology procedures within the first 90 days post-operatively, assessing the indication, outcome, and timing of procedures. Out-of-hours intervention was defined as any procedure undertaken outside of the institution’s regular hours of Monday - Friday, 8am - 4:30pm. Results: 293 pancreaticoduodenectomies were performed during the study period. A total of 212 post-operative interventional radiology procedures were performed on a total of 112 (38%) patients. 152 (71.7%) procedures were completed in-hours whilst 60 (28.3%) procedures performed out-of-hours. The immediate technical and overall success rates were 98.1% and 85.4%, respectively. Conclusion: Almost 30% of patients required out-of-hours emergency Interventional Radiology procedures. Given this finding, the propensity of pancreaticoduodenectomy patients to deteriorate rapidly, and the significant impact of failure to rescue in the morbidity and mortality associated with this operation, we believe that centres performing pancreaticoduodenectomy should have adequate access to Interventional Radiology services with 24-hour availability.