ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
Regionalization and outcomes of hepato-pancreato-biliary cancer surgery in USA.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Gravity Modeling to Predict Patient Choice of Hospital for Pancreaticoduodenectomy.Annals of surgical oncology · 2026Article
- Hospital volume stratification using stratum-specific likelihood ratios for pancreatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026Article
- Reproducibility and Consistency of Methods to Define Hospital-Level Procedural Volume Thresholds for Pancreatectomy.Journal of surgical oncology · 2026Article
- Influence of previous gastrectomy on postoperative bile leakage after laparoscopic liver resection.BMC surgery · 2025Article
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- Exercise and Nutrition Interventions for Prehabilitation in Hepato-Pancreato-Biliary Cancers: A Narrative Review.Nutrients · 2023Review
- Hospital Designations and Their Impact on Guideline-Concordant Care and Survival in Pancreatic Cancer. Do They Matter?Annals of surgical oncology · 2023Article
- Hepatopancreaticobiliary Surgical Outcomes at a Community Hospital.Hawai'i journal of health & social welfare · 2022Article
- Textbook oncologic outcome in pancreaticoduodenectomy: Do regionalization efforts make sense?Journal of surgical oncology · 2022Article
- Applying the Delphi process for development of a hepatopancreaticobiliary robotic surgery training curriculum.Surgical endoscopy · 2020Article
- Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries.International journal of health policy and management · 2019Review
- Prophylactic Pancreatectomies Carry Prohibitive Mortality at Low-Volume Centers: A California Cancer Registry Study.World journal of surgery · 2019Article
- Impact of Travel Time on Health Care Costs and Resource Use by Phase of Care for Older Patients With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019Article
- Impact of pediatric cardiac surgery regionalization on health care utilization and mortality.Health services research · 2019Article
- Contemporary practice and short-term outcomes after liver resections in a complete national cohort.Langenbeck's archives of surgery · 2019Article
- The Importance of Safety-Net Hospitals in Emergency General Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Effects of patient factors on inpatient mortality after complex liver, pancreatic and gastric resections.BJS open · 2017Article
- Training and practice of the next generation HPB surgeon: analysis of the 2014 AHPBA residents' and fellows' symposium survey.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2015Article
- [Papillary tumors - therapeutic concepts].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2015Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent publications demonstrate regionalization of complex operations to high-volume centers (HVCs) in the USA. We hypothesize that this pattern applies to hepato-pancreato-biliary (HPB) cancer resections and improved outcomes.
methodsThe Nationwide Inpatient Sample (NIS) data were analyzed from 1995-1999(T1) to 2005-2009(T2) for all HPB oncologic resections. Division of hospitals into high-, mid-, and low-volume centers (HVC, MVC, LVC) was performed. Multivariate regression was utilized to identify predictors of LVC resection. Outcomes were compared in both eras.
resultsA total of 45,815 cases met the inclusion criteria (19,250 from T1 and 25,565 from T2). At T1, 32.5% of resections were performed at HVCs and 34.9% at LVCs. At T2, 60.8% were performed at HVCs versus 18.5% at LVCs. In T1, inpatient mortality at HVCs versus LVCs was 3.3% versus 8.67% (p < 0.0001) and 2.7% versus 6.5% (p < 0.0001) in T2. LOS and routine discharge were improved in HVCs, but total charges were higher. All outcomes significantly differed between HVCs and LVCs in multivariate analysis, except for LOS and total charges in T2.
conclusionThe most recent NIS data demonstrate better outcomes in HVCs for HPB oncologic resections. These trends reflect alignment with national recommendations to centralize complex cancer surgery, as well as improved outcomes in all centers.
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