Effect of hospital volume, surgeon experience, and surgeon volume on patient outcomes after pancreaticoduodenectomy: a single-institution experience

Archives of Surgery
C Max SchmidtKeith D Lillemoe

Abstract

To determine the importance of hospital volume, surgeon experience, and surgeon volume in performing pancreaticoduodenectomy (PD). From 1980 through 2007, 1003 patients underwent PD by 19 surgeons at a university hospital. Patient morbidity and mortality, quality of resection, and learning curve were examined according to hospital volume (period 1: 1980-2003 vs period 2: 2004-2007), surgeon experience (total number of PDs), and surgeon volume (number of PDs per year). Perioperative morbidity and mortality for all 1003 PDs were 41% and 3%, respectively. Differences existed between period 1 and period 2 in percentage of PDs performed in elderly patients (7% vs 17%), mortality (4% vs 2%), estimated blood loss (1817 mL vs 780 mL), length of stay (18 days vs 12 days), and proportion of International Study Group on Pancreatic Fistula grade C pancreatic fistulae (29% vs 12%). Surgeons with less experience (<50 PDs) performed PD with higher morbidity (53% vs 39%), pancreatic fistula rate (20% vs 10%), estimated blood loss (1918 mL vs 1101 mL), and operative time (458 minutes vs 335 minutes) compared with surgeons with more experience (> or =50 PDs). Experienced surgeons had comparable outcomes irrespective of annual volume. Mortality, ...Continue Reading

Citations

Aug 2, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jordan M CloydJeffrey A Norton
Jan 7, 2014·Annals of Surgical Oncology·Luis SabaterJoaquín Ortega
Dec 4, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Laura M EnomotoChristopher S Hollenbeak
Nov 14, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Daniel M RellesCharles J Yeo
Oct 15, 2013·World Journal of Surgery·Gwendolyn M van der WildenGeorge C Velmahos
Oct 9, 2014·Advances in Surgery·Amer H ZureikatHerbert J Zeh
Nov 16, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Nicolò PecorelliMarco Braga
Oct 29, 2014·Journal of Comparative Effectiveness Research·Katherine E Reeder-HayesAmir H Khandani
Sep 27, 2013·Canadian Journal of Surgery. Journal Canadien De Chirurgie·Meagan E WiebeAlice C Wei
Sep 29, 2011·World Journal of Surgery·Nicolas Christian BuchsPier Cristoforo Giulianotti
Mar 19, 2013·Annals of Surgical Oncology·Jie ZhangYu-Pei Zhao
Jun 26, 2013·Nature Reviews. Gastroenterology & Hepatology·Giuseppe Malleo, Claudio Bassi
Jul 31, 2013·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Keith J RobertsGareth Morris-Stiff
Dec 15, 2011·Polski przeglad chirurgiczny·Beata JabłońskaPaweł Lampe
Dec 2, 2014·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Tao LiXu-Ting Zhi
Oct 7, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Taylor M CoeDavid C Chang
Feb 24, 2015·Current Diabetes Reports·Marina ScaviniLorenzo Piemonti
Mar 1, 2011·Surgical Oncology·Marcelo A OrvietoVipul R Patel
Nov 22, 2016·Journal of Orthopaedic Trauma·Peter L AlthausenTimothy J Bray
May 8, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Andrew J Robson, Rowan W Parks
Feb 17, 2017·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Matthew T McMillanCharles M Vollmer
Jul 30, 2014·Annals of Surgery·Mahiben MaruthappuMatthew J Carty
Mar 7, 2017·Annals of Hepato-biliary-pancreatic Surgery·Radu DumitruTraian Dumitrascu
Feb 22, 2017·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jony van HilstMarc G H Besselink
Feb 14, 2017·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Melissa E HoggUNKNOWN Minimally Invasive Pancreatic Resection Organizing Committee
Mar 29, 2014·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Matthew Z WilsonChristopher S Hollenbeak
Oct 19, 2017·Journal of Surgical Oncology·Anand N SinghPeush Sahni
Jan 1, 2011·Cancers·Konstantinos Karapanos, Iakovos N Nomikos

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