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Pancreaticoduodenectomy - the transition from a low- to a high-volume center.

Ansari, Daniel LU ; Williamsson, Caroline ; Tingstedt, Bobby LU ; Andersson, Bodil LU orcid ; 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)
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author
; ; ; ; and
organization
publishing date
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 (&lt;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 &lt; 0.001). Intraoperative blood loss dropped (p &lt; 0.001). The need for intraoperative blood transfusion was reduced (p &lt; 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}},
}