SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017
The Impact of Surgeon Volume on Outcomes After Pancreaticoduodenectomy: a Meta-analysis.
Synthesis 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 28 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Volume-outcome relationship in anatomical and non-anatomical liver resections: a rapid systematic review.BMC gastroenterology · 2026Pooled it
- Minimally invasive versus open pancreatic surgery: meta-analysis of randomized clinical trials.BJS open · 2023Pooled it
- Mortality factors in pancreatic surgery: A systematic review. How important is the hospital volume?International journal of surgery (London, England) · 2022Pooled it
- Pooled it
- Factors associated with textbook outcome after robotic-assisted pancreatoduodenectomy: a single surgeon's retrospective cohort.Hepatobiliary surgery and nutrition · 2026Article
- Association between volume and cost in low-resection volume regions: a population-level study on pancreatoduodenectomy for pancreatic cancer patients.ANZ journal of surgery · 2025Article
- Significance of blood culture testing after pancreatoduodenectomy.Annals of gastroenterological surgery · 2024Article
- Defining Volume Targets for Regionalization of Pancreaticoduodenectomy, Esophagectomy, and Major Lung Resection Centers to Improve Oncologic and Surgical Outcomes.Annals of surgical oncology · 2024Article
- Nationwide Outcomes of Pancreaticoduodenectomy for Pancreatic Malignancies: Center Volume Matters.The American surgeon · 2023Article
- Associations Between Patient Characteristics and Whipple Procedure Outcomes Before and After Implementation of an Enhanced Recovery After Surgery Protocol.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study.Annals of surgical oncology · 2023Article
- Perioperative oncolytic virotherapy to counteract surgery-induced immunosuppression and improve outcomes in pancreatic ductal adenocarcinoma.Frontiers in oncology · 2023Review
- Does the Volume-Outcome Association in Pancreas Cancer Surgery Justify Regionalization of Care? A Review of Current Controversies.Annals of surgical oncology · 2022Review
- ASO Author Reflections: Understanding the Broader Implications of the Volume-Outcome Impact on Pancreas Cancer Surgery.Annals of surgical oncology · 2022Article
- First World Consensus Conference on pancreas transplantation: Part II - recommendations.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Traveling to Receive Treatment for Extremity Soft Tissue Sarcomas: Is it worth the drive?World journal of surgery · 2021Article
- Total pancreatectomy as alternative to pancreatico-jejunal anastomosis in patients with high fistula risk score: the choice of the fearful or of the wise?Langenbeck's archives of surgery · 2021Observational
- Multidisciplinary consensus statement on the clinical management of patients with pancreatic cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020Article
- Critical evaluation of quality of hepatopancreatic surgery in a medium-volume center in Finland using the Accordion Severity Grading System and the Postoperative Morbidity Index.Journal of gastrointestinal oncology · 2020Article
- Association of Surgeon Case Numbers of Pancreaticoduodenectomies vs Related Procedures With Patient Outcomes to Inform Volume-Based Credentialing.JAMA network open · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite significant improvement in operative mortality rates following pancreaticoduodenectomy (PD), morbidity remains high. Outcomes following PD may be improved in high-volume centers and with high-volume surgeons. We sought to evaluate the association between surgeon experience and postoperative outcomes after PD.
methodsAn online database search of MEDLINE and EMBASE was performed; key bibliographies were reviewed. Studies comparing operative outcomes of high-volume surgeon (HVS) and low-volume surgeon (LVS) performing PD were included. Odds ratios with the corresponding 95% confidence intervals (CI) by random fixed effects models of pooled data were calculated. Definition of HVS varied among the studies, ranging from 6 to >20 PD/year. The primary endpoint was 30-day mortality, and secondary outcomes were complication rates, length of stay (LOS), hospital costs, and readmission rates. Study quality was assessed using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria.
resultsSearch strategy yielded 360 publications. Eleven studies met the inclusion criteria comprising 36,449 patients. Among these patients, 12,512 (34.3%) PDs were performed by HVS and 23,937 (65.7%) by LVS. Meta-analysis of included studies showed that HVS had significantly lower mortality rates than LVS (2.4 vs. 6.7%, OR 2.88; 95% CI 2.51-3.27, p < 0.001). They also had significantly lower overall complication rates (36.3 vs. 50.3%, OR 1.71; 95% CI 1.62-1.81, p < 0.001), hospital costs (range $10,818-141,322 vs. $12,114-198,678, OR 0.13; 95% CI 0.07-0.19, p < 0.001), and LOS (range 11-35 vs. 14-38 days, OR 2.86; 95% CI 2.03-3.68, p < 0.001).
conclusionsHVS performing PD have significantly better outcomes than LVS in terms of decreased mortality, morbidity, LOS, and hospital costs. Efforts toward increased regionalization of care should be discussed. Consensus regarding definition of HVS needs to be undertaken.
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Registered trials
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.