ArticleAnnals of surgical oncology2022
Determining Hospital Volume Threshold for Safety of Minimally Invasive Pancreaticoduodenectomy: A Contemporary Cutpoint Analysis.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Laparoscopic versus open pancreatoduodenectomy: a pilot randomized trial in a developing African country.Surgical endoscopy · 2026Trial
- Gravity Modeling to Predict Patient Choice of Hospital for Pancreaticoduodenectomy.Annals of surgical oncology · 2026Article
- Defining the role of endoscopic resection for esophageal gastrointestinal stromal tumors.Journal of gastrointestinal 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
- Increase in Pancreatoduodenectomy Volume at Mid-Volume Facilities in the United States: A National Cancer Database Analysis.Annals of gastroenterological surgery · 2026Article
- Reproducibility and Consistency of Methods to Define Hospital-Level Procedural Volume Thresholds for Pancreatectomy.Journal of surgical oncology · 2026Article
- Impact of hospital sepsis case volume on mortality in sepsis patients: a meta-analysis.Frontiers in medicine · 2026Review
- Impact of Patient Income and Insurance on Postoperative Mortality After Total Pancreatectomy for Pancreatic Neoplasms.Journal of surgical oncology · 2025Article
- Laparoscopic versus open pancreaticoduodenectomy for pancreatic or periampullary tumors: a multicenter propensity score-matched comparative study.Surgical endoscopy · 2025Article
- A Comparative Analysis of Open Versus Minimally Invasive Pancreatoduodenectomies.Journal of surgical oncology · 2025Article
- Initiation of a robotic pancreatoduodenectomy program using virtual collaboration.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2024Article
- Comparing oncologic and surgical outcomes of robotic and laparoscopic pancreatoduodenectomy in patients with pancreatic cancer: a propensity-matched analysis.Surgical endoscopy · 2024Article
- ASO Author Reflections: Prognostic Significance of Perineural Invasion in Upper Tract Urothelial Carcinoma.Annals of surgical oncology · 2022Article
- ASO Author Reflections: An Objective Hospital Volume Threshold for Minimally Invasive Pancreaticoduodenectomy.Annals of surgical oncology · 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
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGuidelines recommend limiting minimally invasive pancreaticoduodenectomy (MIPD) to high-volume centers. However, the definition of high-volume care remains unclear. We aimed to objectively define a minimum number of MIPD performed annually per hospital associated with improved outcomes in a contemporary patient cohort. PATIENTS AND
methodsResectable pancreatic adenocarcinoma patients undergoing MIPD were included from the National Cancer Database (2010-2017). Multivariable modeling with restricted cubic splines was employed to identify an MIPD annual hospital volume threshold associated with lower 90-day mortality. Outcomes were compared between patients treated at low-volume (≤ model-identified cutoff) and high-volume (> cutoff) centers.
resultsAmong 3079 patients, 141 (5%) died within 90 days. Median hospital volume was 6 (range 1-73) cases/year. After adjustment, increasing hospital volume was associated with decreasing 90-day mortality for up to 19 (95% CI 16-25) cases/year, indicating a threshold of 20 cases/year. Most cases (82%) were done at low-volume (< 20 cases/year) centers. With adjustment, MIPD at low-volume centers was associated with increased 90-day mortality (OR 2.7; p = 0.002). Length of stay, positive surgical margins, 30-day readmission, and overall survival were similar. On analysis of the most recent two years (n = 1031), patients at low-volume centers (78.2%) were younger and had less advanced tumors but had longer length of stay (8 versus 7 days; p < 0.001) and increased 90-day mortality (7% versus 2%; p = 0.009).
conclusionsThe cutpoint analysis identified a threshold of at least 20 MIPD cases/year associated with lower postoperative mortality. This threshold should inform national guidelines and institution-level protocols aimed at facilitating the safe implementation of this complex procedure.
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