Pancreaticoduodenectomy - the transition from a low- to a high-volume center.
Ansari, Daniel LU ; Williamsson, Caroline ; Tingstedt, Bobby LU ; Andersson, Bodil LU
; Lindell, Gert
LU
and Andersson, Roland
LU
(2014)
In Scandinavian Journal of Gastroenterology
49(4).
p.481-484
- Abstract
- Abstract Objective. Previous studies have identified a significant volume-outcome relationship for hospitals performing pancreaticoduodenectomy (PD). However, scant information exists concerning the effects of increased caseload of PD within the same hospital. Here, we describe the effects of becoming a high-volume provider of PD. Material and methods. The study group comprised 221 patients who underwent PD between 2000 and 2012. Hospital volume was allocated into three groups: low-volume (<10 PDs/year), years 2000-2004, n = 25; medium-volume (10-24 PDs/year), years 2005-2009, n = 86; and high-volume (≥25 PDs/year), years 2010-2012, n = 110. Results. The annual number of PDs increased from 5 in 2000 to 39 in 2012. The median operative... (More)
- Abstract Objective. Previous studies have identified a significant volume-outcome relationship for hospitals performing pancreaticoduodenectomy (PD). However, scant information exists concerning the effects of increased caseload of PD within the same hospital. Here, we describe the effects of becoming a high-volume provider of PD. Material and methods. The study group comprised 221 patients who underwent PD between 2000 and 2012. Hospital volume was allocated into three groups: low-volume (<10 PDs/year), years 2000-2004, n = 25; medium-volume (10-24 PDs/year), years 2005-2009, n = 86; and high-volume (≥25 PDs/year), years 2010-2012, n = 110. Results. The annual number of PDs increased from 5 in 2000 to 39 in 2012. The median operative duration decreased over the volume categories (p < 0.001). Intraoperative blood loss dropped (p < 0.001). The need for intraoperative blood transfusion was reduced (p < 0.001). Increasing hospital volume was associated with fewer reoperations (p = 0.041) and shorter postoperative length of stay (p = 0.010). There was a tendency toward reduced mortality: 4.0% for the low-volume period, 2.3% for the medium-volume period, and 0% for the high-volume period (p = 0.066). Conclusions. The transition from a low- to a high-volume center resulted in optimized outcomes for PD and 0% operative mortality, favoring the continued centralization of this high-risk operation. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4179110
- author
- Ansari, Daniel
LU
; Williamsson, Caroline
; Tingstedt, Bobby
LU
; Andersson, Bodil
LU
; Lindell, Gert
LU
and Andersson, Roland
LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Gastroenterology
- volume
- 49
- issue
- 4
- pages
- 481 - 484
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:24255988
- wos:000333350100011
- scopus:84896930007
- pmid:24255988
- ISSN
- 1502-7708
- DOI
- 10.3109/00365521.2013.847116
- language
- English
- LU publication?
- yes
- id
- 6b2cb727-2739-4f0a-b79e-cdde1d2d99df (old id 4179110)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/24255988?dopt=Abstract
- date added to LUP
- 2016-04-01 10:03:08
- date last changed
- 2022-04-12 01:26:05
@article{6b2cb727-2739-4f0a-b79e-cdde1d2d99df,
abstract = {{Abstract Objective. Previous studies have identified a significant volume-outcome relationship for hospitals performing pancreaticoduodenectomy (PD). However, scant information exists concerning the effects of increased caseload of PD within the same hospital. Here, we describe the effects of becoming a high-volume provider of PD. Material and methods. The study group comprised 221 patients who underwent PD between 2000 and 2012. Hospital volume was allocated into three groups: low-volume (<10 PDs/year), years 2000-2004, n = 25; medium-volume (10-24 PDs/year), years 2005-2009, n = 86; and high-volume (≥25 PDs/year), years 2010-2012, n = 110. Results. The annual number of PDs increased from 5 in 2000 to 39 in 2012. The median operative duration decreased over the volume categories (p < 0.001). Intraoperative blood loss dropped (p < 0.001). The need for intraoperative blood transfusion was reduced (p < 0.001). Increasing hospital volume was associated with fewer reoperations (p = 0.041) and shorter postoperative length of stay (p = 0.010). There was a tendency toward reduced mortality: 4.0% for the low-volume period, 2.3% for the medium-volume period, and 0% for the high-volume period (p = 0.066). Conclusions. The transition from a low- to a high-volume center resulted in optimized outcomes for PD and 0% operative mortality, favoring the continued centralization of this high-risk operation.}},
author = {{Ansari, Daniel and Williamsson, Caroline and Tingstedt, Bobby and Andersson, Bodil and Lindell, Gert and Andersson, Roland}},
issn = {{1502-7708}},
language = {{eng}},
number = {{4}},
pages = {{481--484}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Gastroenterology}},
title = {{Pancreaticoduodenectomy - the transition from a low- to a high-volume center.}},
url = {{http://dx.doi.org/10.3109/00365521.2013.847116}},
doi = {{10.3109/00365521.2013.847116}},
volume = {{49}},
year = {{2014}},
}