ArticleJournal of hepato-biliary-pancreatic sciences2025
Trends in the Outcomes of Advanced Hepatobiliary-Pancreatic Surgery: The Impact of a Nationwide Clinical Database and Surgeon Certification System.
Article in Journal of hepato-biliary-pancreatic sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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7 authors.
Funding
Abstract
backgroundThe Japanese Society of Hepatobiliary and Pancreatic Surgery has established a certification system for experienced surgeons. Evaluating its efficacy requires accounting for patient risk variations. The National Clinical Database (NCD) facilitates this using risk-adjusted outcome measures to validate and compare surgical performance.
methodsWe analyzed the NCD from 2014 to 2020 to examine trends in adjusted odds ratios (AORs) for mortality and morbidity following pancreaticoduodenectomy using 2014 as the reference. Primary outcomes were surgical and 30-day postoperative mortality. Secondary outcomes included severe complications and grade C pancreatic fistula. Subgroup analyses considered surgeon and institutional certification.
resultsAnalysis of 78 972 pancreaticoduodenectomy reports revealed a decrease in the AOR for surgical mortality from 0.906 (95% Confidence Interval [CI]: 0.759-1.082, p = 0.276) in 2015 to 0.647 (95% CI: 0.539-0.777, p < 0.001) in 2020. A significant downward trend in the incidence of Grade C pancreatic fistula was observed. Board-certified surgeons have demonstrated superior performance compared to nonboard-certified surgeons since 2014, with board-certified training institutions having significantly lower AORs than those without certification. The AOR for surgical mortality showed an annual decrease across institutions.
conclusionsThe certification system for hepatobiliary-pancreatic surgery and participation in the NCD significantly decreased surgical mortality after pancreaticoduodenectomy.
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