The required experience of open pancreaticoduodenectomy before becoming a specialist in hepatobiliary and pancreatic surgeons: a multicenter, cohort study of 334 open pancreaticoduodenectomies

Open pancreaticoduodenectomy (OPD) is an essential surgical procedure for expert hepato-biliary-pancreatic (HBP) surgeons. However, there is no standard for how many surgeries must be performed by a surgeon in training before they are considered to have enough experience to ensure surgical safety. C...

Full description

Saved in:
Bibliographic Details
Published in:BMC surgery 2024-11, Vol.24 (1), p.366-9, Article 366
Main Authors: Fuji, Tomokazu, Umeda, Yuzo, Takagi, Kosei, Hioki, Masayoshi, Yoshida, Ryuichi, Endo, Yoshikatsu, Yasui, Kazuya, Nobuoka, Daisuke, Mitsuhashi, Toshiharu, Fujiwara, Toshiyoshi
Format: Article
Language:English
Subjects:
Aged
Analysis
Bile ducts
Blood
Blood Loss, Surgical - statistics & numerical data
Cholangiocarcinoma
Clinical Competence
Cohort analysis
Cohort Studies
Education
Female
Health aspects
High-volume hospital
Hospitals
Humans
Inflection points
Japan
Learning curve
Learning curves
Length of Stay - statistics & numerical data
Male
Medical societies
Middle Aged
Mortality
Operative Time
Pancreas
Pancreatic cancer
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy
Pancreaticoduodenectomy - methods
Postoperative Complications - epidemiology
Regression analysis
Retrospective Studies
Risk factors
Surgeons
Surgeons - education
Surgeons - statistics & numerical data
Surgery
Surgical outcomes
Training
Tumors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Open pancreaticoduodenectomy (OPD) is an essential surgical procedure for expert hepato-biliary-pancreatic (HBP) surgeons. However, there is no standard for how many surgeries must be performed by a surgeon in training before they are considered to have enough experience to ensure surgical safety. Cumulative Sum (CUSUM) analysis was performed using the surgical data of OPDs performed during the training period of board-certified expert surgeons of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Fourteen HBP surgeons participated in this study and performed 334 OPDs during their training period. The median (interquartile range) values for operative time, blood loss, and length of hospital stay were 455 (397-519) minutes, 450 (234--716) ml, and 28 (21-38) days, respectively. CUSUM analysis showed inflection points at 20 surgeries performed for operative time. After 20 procedures, operative time was significantly shorter (461 min vs. 425 min, p = 0.021) and blood loss was significantly lower (470 ml vs. 340 ml, p = 0.038). No significant differences between within 20 and after 21 procedures were found in the complication rate (53% vs. 48%, p = 0.424) and rate of in-hospital deaths (1.5% vs.1.4%. p = 0.945). Up to 20 surgeries, PDAC and another malignant tumor had longer operative time than benign/low malignant diseases (486 min vs. 472 min vs. 429 min, p 
ISSN:1471-2482
1471-2482
DOI:10.1186/s12893-024-02677-9