Evidence map›Paper›PMID 42635708›Full record

ArticleUpdates in surgery2026

Pancreatic cancer surgery in Italy: an updated snapshot from a national multicentre analysis of outcomes by hospital volume.

Stefano Crippa, Giulio Belfiori, Federico De Stefano, Gianpaolo Balzano, Francesco Ardito, Andrea Barberis, Ugo Boggi, Fulvio Calise, Silvia Caregari, Fabio Casciani and 59 more

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Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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69 authors.

Stefano CrippaDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. crippa.stefano@hsr.it.ORCID http://orcid.org/0000-0002-7370-1508
Giulio BelfioriDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Federico De StefanoDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Gianpaolo BalzanoDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Francesco ArditoHepatobiliary Surgery Unit, Foundation "Policlinico Universitario A. Gemelli", IRCCS, Catholic University, Rome, Italy.
Andrea BarberisDepartement of Abdominal Surgery, General and Hepatobiliopancreatic Surgery Unit, E.O. Ospedali Galliera, Genoa, Italy.
Ugo BoggiDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Fulvio CaliseDepartment of General Surgery, Center for Hepatobiliary and Pancreatic Surgery, Pineta Grande Hospital, Castel Volturno, Italy.
Silvia CaregariDepartment of General and Oncological Surgery, Umberto I Mauriziano Hospital, Turin, Italy.
Fabio CascianiGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
Marco Angelo CeredaDepartment of Surgery, San Gerardo University Hospital, Monza, Italy.
Leonardo CentonzeDepartment of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy.
Nicola CillaraDepartment of Surgery PO SS. Trinità, Cagliari, Italy.
Umberto CilloHepato-Pancreato-Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Eugenio CocozzaSurgical Oncology and Minimally Invasive Unit, ASST Sette Laghi, Varese, Italy.
Annalisa ComandatoreGeneral Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Antonello DeserraDepartment of Surgery PO SS. Trinità, Cagliari, Italy.
Giulia DeianaUnit of General Surgery 2, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Gregorio Di FrancoGeneral Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Fabio Francesco Di MolaDepartment of Innovative Technologies in Medicine and Dentistry, G. D'annunzio University Pescara-Chieti, Pescara, Italy.
Francesca Di SalvoDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Pierluigi Di SebastianoDepartment of Innovative Technologies in Medicine and Dentistry, G. D'annunzio University Pescara-Chieti, Pescara, Italy.
Stefano D'UgoHepato-Bilio-Pancreatic Surgery, "V. Fazzi" Hospital, Lecce, Italy.
Giorgio ErcolaniDepartment of Medical and Surgical Sciences, Morgagni-Pierantoni Hospital, University of Bologna, Forlì, Italy.
Giuseppe Maria EttorreDivision of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy.
Giovanni Carlo FerrariDivision of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Alessandro FerreroDepartment of General and Oncological Surgery, Umberto I Mauriziano Hospital, Turin, Italy.
Gianluca GarulliGeneral Surgery Division, Ospedale Infermi, Rimini, Italy.
Alessandro GianiDivision of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Luca Vittorio GianottiDepartment of Surgery, San Gerardo University Hospital, Monza, Italy.
Tommaso GiulianiDepartment of Medical and Surgical Sciences, Morgagni-Pierantoni Hospital, University of Bologna, Forlì, Italy.
Felice GiulianteHepatobiliary Surgery Unit, Foundation "Policlinico Universitario A. Gemelli", IRCCS, Catholic University, Rome, Italy.
Alfredo GuglielmiDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
Emanuele KauffmannDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Serena LangellaDepartment of General and Oncological Surgery, Umberto I Mauriziano Hospital, Turin, Italy.
Andrea LauterioDepartment of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy.
Gabriella LionettoGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
Lorenzo LivraghiSurgical Oncology and Minimally Invasive Unit, ASST Sette Laghi, Varese, Italy.
Giuseppe MalleoGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
Giovanni MarchegianiHepato-Pancreato-Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Marco MassaniDepartment of Surgery, Regional Hospital of Treviso, Treviso, Italy.
Michele MazzolaDivision of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Riccardo MemeoDivision of Hepato-Pancreato-Biliary Surgery, "F. Miulli" General Hospital, Acquaviva Delle Fonti, Bari, Italy.
Roberto Luca MeniconiDivision of General Surgery and Liver Transplantation, San Camillo Hospital, Rome, Italy.
Luca MorelliGeneral Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Gennaro NappoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Niccolo' NapoliDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Cristina NistriDepartment of Surgery, Regional Hospital of Treviso, Treviso, Italy.
Michele PagnanelliDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Alberto PatritiOspedali Riuniti Marche Nord, Pesaro, Italy.
Filippo PetrelliOspedali Riuniti Marche Nord, Pesaro, Italy.
Edoardo PolettoDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
Alberto PorcuUnit of General Surgery 2, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Alessandro PuzzielloGeneral Surgery Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy.
Claudio RicciDepartment of Internal Medicine and Surgery, Alma Mater StudiorumSant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Allegra RipolliDivision of General and Transplant Surgery, University of Pisa, Pisa, Italy.
Roberta RossiHepatopancreatobiliary and Transplant Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy.
Andrea RuzzenenteDivision of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.
Giulia SandroniDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Giuseppe SenaDipartimento Specialità Chirurgiche, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
Marcello SpampinatoHepato-Bilio-Pancreatic Surgery, "V. Fazzi" Hospital, Lecce, Italy.
Cosimo SpertiHepato-Pancreato-Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Michele TedeschiDivision of Hepato-Pancreato-Biliary Surgery, "F. Miulli" General Hospital, Acquaviva Delle Fonti, Bari, Italy.
Luigi VeneroniGeneral Surgery Division, Ospedale Infermi, Rimini, Italy.
Marco VivarelliHepatopancreatobiliary and Transplant Unit, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy.
Alessandro ZerbiDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Roberto SalviaGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
Riccardo CasadeiDepartment of Internal Medicine and Surgery, Alma Mater StudiorumSant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Massimo FalconiDivision of Pancreatic Surgery, Department of Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAlthough surgical volume has a well-known association with outcomes in pancreatic surgery, volume alone does not necessarily guarantee quality for pancreatic ductal adenocarcinoma (PDAC). The study aimed to provide an overview of current surgical practices and short-term outcomes for PDAC in Italy.

methodsA retrospective multicentre study was conducted including all patients who underwent surgery for PDAC at 29 centers between 2018 and 2021. Centers were categorized by annual pancreatic surgical volume as low (1-10), medium (11-50), high (51-100), and very-high (> 100). The primary outcome was 90-day postoperative mortality.

resultsA total of 3455 patients were included, treated in low- (n = 26), medium- (n = 1103), high- (n = 322), and very-high-volume (n = 2004) centers. The median PDAC-surgeries per year was 27 (IQR 23-28) in high- and 107 (IQR 64-204) in very-high-volume centers. Preoperative histological diagnosis was obtained in 66.6% of cases (n = 1335/2004) in very-high, 45.7% (n = 504/1103) in medium-, and 23.3% (n = 75/322) in high-volume centers. The overall resection rate was 90.7% (n = 3134/3455), while the remainder underwent exploration or palliative surgery. Ninety-day mortality among resected cases was 10% (n = 2/20), 5.3% (n = 51/961), 5.1% (n = 15/294), and 3.4% (n = 63/1859) in low-, medium-, high-, and very-high-volume centers, respectively.

conclusionConsiderable heterogeneity persists in PDAC management across Italy. According to the national criteria for the accreditation of Pancreas Units, 21.5% of patients could be treated in centers that fail to meet minimum standards, while an additional 5.9% receive care in high-volume centers where the 90-day mortality still exceeds 5%.

Indexed as

PancreasPancreas unitsPancreatic cancerPancreatic ductal adenocarcinomaVolume in surgery

Identifiers

PMID42635708

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