Implementation of a regional reference center in pancreatic surgery. Experience after 631 procedures

Juan Manuel Castillo Tuñón; María Elisa Valle Rodas; Francisco Botello Martínez; Adela Rojas Holguín; Diego López Guerra; Jesús Santos Naharro; Isabel Jaén Torrejímeno; Gerardo Blanco Fernández

doi:10.1016/j.ciresp.2020.09.013

Implementation of a regional reference center in pancreatic surgery. Experience after 631 procedures

Cir Esp (Engl Ed). 2020 Dec 17:S0009-739X(20)30313-4. doi: 10.1016/j.ciresp.2020.09.013. Online ahead of print.

[Article in English, Spanish]

Authors

Juan Manuel Castillo Tuñón¹, María Elisa Valle Rodas², Francisco Botello Martínez², Adela Rojas Holguín², Diego López Guerra², Jesús Santos Naharro², Isabel Jaén Torrejímeno², Gerardo Blanco Fernández²

Affiliations

¹ Hospital Universitario de Badajoz, Badajoz, España. Electronic address: juanmanuel.castillo@salud-juntaex.es.
² Hospital Universitario de Badajoz, Badajoz, España.

PMID: 33342520
DOI: 10.1016/j.ciresp.2020.09.013

Abstract

Introduction: The main objective of this study is to determine if our unit meets the quality standards required by the scientific community from the reference centers for pancreatic surgery in terms of peri-operative results. The secondary objectives are to compare the different pancreatic surgery techniques performed in terms of early post-operative morbidity and mortality and to analyze the impact of the resections added in these terms.

Method: Descriptive, retrospective and single-center study, corresponding to the period 2006-2019. The results obtained were compared with the proposed quality standards, by Bassi et al. and Sabater et al., required from the reference centers in pancreatic surgery. The sample was divided according to surgical technique and compared in terms of early post-operative morbidity and mortality, studying the impact of extended vascular and visceral resections. All patients undergoing pancreatic surgery in our unit due to pancreatic, malignant and benign pathology were included, since it was implemented as a reference center. Emergency procedures were excluded.

Results: 631 patients were analyzed. The values ??obtained in the quality standards are in range. The most frequent surgery was cephalic duodenopancreatectomy, which associated higher peri-operative morbidity and mortality rates (p ≤ 0.05). The extended vascular resections impacted the cephalic duodenopancreatectomy group, associating a longer mean stay (p = 0.01) and a higher rate of re-interventions (p = 0.02).

Conclusions: The experience accumulated allows to meet the required quality standards, as well as perform extended resections to pancreatectomy with good results in terms of post-operative morbi-mortality.

Keywords: Centro de referencia; Cirugía pancreática; Estándares de calidad; Morbi-mortality; Morbimortalidad; Pancreatic surgery; Quality standar; Referrence center; Resecciones vasculares; Resecciones viscerales; Vascular resection; Visceral resection.