ArticleWorld journal of surgery2014
Pancreaticoduodenectomy: outcomes in a low-volume, specialised Hepato Pancreato Biliary unit.
Article in World journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Mortality and postoperative complications after different types of surgical reconstruction following pancreaticoduodenectomy-a systematic review with meta-analysis.Langenbeck's archives of surgery · 2019Pooled it
- Article
- Surgeon's Experience May Circumvent Operative Volume in Improving Early Outcomes After Pancreaticoduodenectomy.Cureus · 2023Article
- Outcome after implementation of a clinical pathway for pancreaticoduodenectomy in a low volume centre.Contemporary oncology (Poznan, Poland) · 2022Article
- Postoperative Outcomes Analysis After Pancreatic Duct Occlusion: A Safe Option to Treat the Pancreatic Stump After Pancreaticoduodenectomy in Low-Volume Centers.Frontiers in surgery · 2021Article
- Influence of trends in hospital volume over time on patient outcomes for high-risk surgery.BMC health services research · 2020Observational
- One hundred sixty pancreaticoduodenectomies for periampullary cancers in a growing-volume setting: a single-institution and a single-surgeon's experience.Annals of surgical treatment and research · 2019Article
- Impact of surgeon experience on routine prolapse operations.International urogynecology journal · 2018Article
- Impact of surgical experience on management and outcome of pancreatic surgery performed in high- and low-volume centers.Updates in surgery · 2017Article
- The Impact of Increasing Hospital Volume on 90-Day Postoperative Outcomes Following Pancreaticoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Observational
- The 13-year experience of performing pancreaticoduodenectomy in a mid-volume municipal hospital.Annals of surgical treatment and research · 2017Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study was designed to evaluate the outcomes of pancreaticoduodenectomy (PD) at a low-volume specialised Hepato Pancreato Biliary (HPB) unit. Volume outcome analyses show significantly better results for patients undergoing PD at high-volume centres (Begg et al. JAMA 280:1747-1751, 1998; Finlayson et al. Arch Surg 138:721-725, 2003; Birkmeyer et al. N Engl J Med 346:1128-1137, 2002; Gouma et al. Ann Surg 232:786-795, 2000). Centralisation of PD seems to be the logical conclusion to be drawn from these results. In countries like Australia with a small and widely dispersed population, centralisation may not be always feasible. Alternative strategy would be to have similar systems in place to those in high-volume centres to achieve similar results at low-volume centres. Many Australian tertiary care centres perform low to medium volumes of PD (Chen et al. HPB 12:101-108, 2010; Kwok et al. ANZ J Surg 80:605-608, 2010; Barnett and Collier ANZ J Surg 76:563-568, 2006; Samra et al. Hepatobiliary Pancreat Dis Int 10:415-421, 2011). Most of these have a specialised HPB unit, accredited by the Australia and New Zealand Hepatic pancreatic and biliary association (ANZHPBA), as training units for post fellowship training in HPB surgery. It is imperative to perform outcome-based analyses in these units to ensure safety and high quality of care.
methodsRetrospective analysis of database for periampullary carcinoma (1998 till date) was performed in an ANZHPBA accredited HPB unit based at a tertiary care teaching hospital in South Australia. Because age older than 74 years is shown to be a predictive marker of increased morbidity and mortality after a PD, we analysed the outcomes in this subset of patients separately.
resultsFifty-three patients underwent PD in 14 years. Overall mortality was 3.8 %. The last in hospital mortality was in 1999. The morbidity rates and the oncologic outcomes were similar to those in high-volume units.
conclusionsPD can be safely performed in a low-volume specialised unit at centres where the amenities and processes at high-volume centres can be replicated.
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