[Building a private high-volume center for pancreatic resection]

Acta Gastroenterol Latinoam. 2014;44(3):233-8.
[Article in Spanish]

Abstract

Introduction: There is considerable evidence on the direct relationship between higher volume and lower mortality in the pancreatoduodenectomy (DPC). However, there is little evidence of morbidity and mortality in the process of building a high-volume pancreatic surgery center. Objective. To evaluate the morbidity and mortality of the DPC in the process of building a high-volume center for pancreatic resection.

Methods: All consecutive patients undergoing DPC from July 2007 through July 2009 at a single center were included. High volume center was defined as that doing more than 19 DPC per year and high volume surgeon as that doing 16 or more DPC per year. The analysis of data was carried out in two periods according to the number of DPC per year: the first (1998 to 2005) as low volume center and the second (2006 to 2012) as high volume center.

Results: Three hundred and thirty five DPC were conducted consecutively. All surgeries were performed by a high volume surgeon. One hundred and seven patients were operated in the first period and 228 in the second period. There were no significant differences in morbidity and mortality between the both periods. In the second period there were significantly less operative time and minor length ofstay.

Conclusions: High volume surgeons in pancreatic surgery can transfer their experience to the creation of a high volume pancreatic surgery center without sacrificing the morbidity and mortality.

MeSH terms

  • Adult
  • Aged
  • Clinical Competence / statistics & numerical data*
  • Female
  • Hospitals, High-Volume / statistics & numerical data*
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Morbidity
  • Operative Time
  • Pancreatectomy / adverse effects
  • Pancreatectomy / statistics & numerical data
  • Pancreatic Fistula / mortality
  • Pancreaticoduodenectomy / adverse effects*
  • Pancreaticoduodenectomy / mortality
  • Pancreaticoduodenectomy / statistics & numerical data
  • Postoperative Hemorrhage / mortality
  • Postoperative Period
  • Surgeons / statistics & numerical data
  • Treatment Outcome
  • Young Adult