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Howard A. Reber, MD; O. Joe Hines, MD

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In reply

We thank Drs Conway and Gagandeep for their comments. We agree that the EBL is less accurate than one might wish, and in our review of the University of California–Los Angeles experience with resection for pancreatic cancer, the recorded EBL value was that of the anesthesiologist’s, taken from the operative record. Because our report is a retrospective case series, the suggestion that EBL values were biased because they were being used as a performance indicator or end point is incorrect. The anesthesiologists (none of whom were coauthors of the article) "called it as they saw it" during the entire study period, and the data speak for themselves.

Drs Conway and Gagandeep also suggest that the selection of patients with less aggressive or advanced disease might allow for resections with less blood loss and that such patients might inherently have better . . . [Full Text of this Article]

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RELATED LETTER

Operative Blood Loss and Survival in Pancreatic Cancer
William Charles Conway and Singh Gagandeep
Arch Surg. 2009;144(6):594.
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