由于胰腺手术的复杂性，被诊断为胰腺导管腺癌（PDAC）的患者可能会寻求不止一位外科医生的意见。关于第二次手术意见如何影响胰腺切除术和围手术期结果的可能性，人们知之甚少。我们的研究旨在确定获得第二手术意见对胰腺切除率的影响，并评估其对手术结果的影响。使用 100% 医疗保险住院和门诊标准分析文件 (SAF) 来识别 2013 年至 2020 年期间诊断为 PDAC 的患者。收集的数据包括咨询的外科医生数量和地理区域。比较接受超过一次外科会诊的患者的胰腺切除术和围手术期结果。在 116,072 名诊断为 PDAC 的患者中，10,640 名 (9.2%) 接受了胰腺切除术。在 1,906 名 (17.9%) 经第二意见后接受胰腺切除术的患者中，39.7% (n=756) 接受了最初外科医生的切除术。接受第二次手术意见的患者更有可能接受胰腺切除术（调整后比值比 [aOR] 6.17；95% CI 5.78-6.59），农村患者的比值降低（aOR 5.57；95% CI：4.64-6.69）。接受手术并接受第二意见的患者与未寻求第二意见的患者相比，住院时间和并发症发生率相同（均 p>0.05）。在因胰腺癌而接受胰腺切除术的 Medicare 患者中，大约七分之一的患者接受了胰腺切除术第二次手术意见。需要进一步研究第二意见对长期癌症特异性结果的影响。版权所有 © 2024 美国外科医生学会。由 Wolters Kluwer Health, Inc. 出版。保留所有权利。

Due 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.Patients 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.Of 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).Among 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.