Observational studyJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017
The Impact of Increasing Hospital Volume on 90-Day Postoperative Outcomes Following Pancreaticoduodenectomy.
Observational study in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Mortality factors in pancreatic surgery: A systematic review. How important is the hospital volume?International journal of surgery (London, England) · 2022Pooled it
- Centralisation of Pancreatoduodenectomy in India: Where Do We Stand?World journal of surgery · 2020Pooled it
- Assessing the interplay of operative volume at the hospital and surgeon level for pancreatic cancer.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026Article
- Significance of Self-Expandable Metallic Stent for Postoperative Intra-Abdominal Infection After Pancreatoduodenectomy in Patients With a Hard Pancreas.Annals of gastroenterological surgery · 2026Article
- ASO Author Reflections: Improving Outcomes and Minimizing Variability in Pancreatic Cancer Care: A Study of Ontario and the United States.Annals of surgical oncology · 2024Article
- Treatment Patterns and Outcomes in Pancreatic Cancer: A Comparative Analysis of Ontario and the USA.Annals of surgical oncology · 2024Article
- The dialysis facility levels and sizes are associated with outcomes of incident hemodialysis patients.Scientific reports · 2021Article
- Early intra-abdominal infection following pancreaticoduodenectomy:associated factors and clinical impact on surgical outcome.Fukushima journal of medical science · 2020Article
- Article
- Practice, Practice, Practice! Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta Volume on Outcomes: Data From the AAST AORTA Registry.The Journal of surgical research · 2020Article
- Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.CA: a cancer journal for clinicians · 2020Review
- Role of lymphadenectomy, adjuvant chemotherapy, and treatment at high-volume centers in patients with resected pancreatic cancer-a distinct view on lymph node yield.Langenbeck's archives of surgery · 2020Article
- Nasogastric Tube on Demand is Rarely Necessary After Pancreatoduodenectomy Within an Enhanced Recovery Pathway.World journal of surgery · 2019Observational
- Centralization of Pancreatic Surgery in Europe.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Review
- Association Between Travel Distance, Hospital Volume, and Outcomes Following Resection of Cholangiocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Factors associated with receipt of symptom screening in the year after cancer diagnosis in a universal health care system: a retrospective cohort study.Current oncology (Toronto, Ont.) · 2019Article
- Article
- Changes in preoperative endoscopic and percutaneous bile drainage in patients with periampullary cancer undergoing pancreaticoduodenectomy in Ontario: effect on clinical practice of a randomized trial.Current oncology (Toronto, Ont.) · 2018Observational
- Recent Advances in Pancreatic Cancer Surgery.Current treatment options in gastroenterology · 2017Review
- Postoperative complications and mortality: Are they unavoidable?Annals of gastroenterological surgery · 2017Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPerformance of pancreaticoduodenectomy (PD) in high-volume centers has been posited to improve postoperative morbidity and mortality, consistent with the volume-outcomes hypothesis. We sought to evaluate the impact of hospital volume on 90-day PD outcomes at hepatopancreatobiliary (HPB) centers within a regionalized system.
methodsA retrospective population-based observational cohort study was performed, using administrative records of patients undergoing PD between 2005 and 2013 in Ontario, Canada. Postoperative administrative codes were used to define complications. Patients' 90-day postoperative outcomes were compared between center-volume categories using chi-square tests and multivariable regression. Volume cutoffs were defined using minimal regional standards (20PD/year), with assessment of the impact of further volume increases.
resultsOf 2660 patients, 2563 underwent PD at HPB centers. Of these, 38.9% underwent surgery at higher-volume centers (>40 PD/year), 36.9% at medium-volume centers (20-39 PD/year), and 24.1% at lower-volume centers (10-19 PD/year). Mortality (30- and 90-day) was lowest at higher-volume hospitals (1.5%, 2.7%, respectively) compared to medium-volume (3.9%, 6.3%) and lower-volume hospitals (2.9%, 5.2%) (p < 0.01). Patients treated at higher- and medium-volume centers had lower reoperation rates (10.3%, 10.7% vs. 16.7%, p = 0.0002) and less prolonged length of stay (23.2%, 22.0% vs. 31.6%, p < 0.0001) compared to lower-volume centers.
conclusionProgressive increases in hospital volume correspond to improved 90-day outcomes following PD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.