Effect of Surgeon Volume on Outcome of Pancreaticoduodenectomy

Università Vita-Salute San Raffaele

Status: Completed

Conditions: Pancreatic Surgery; Pancreatic Cancer

Treatments: Procedure: Pancreaticoduodenectomy

Study type: Interventional

Funder types: Other

Identifiers

NCT01059097

PANCREAS2010

Details and patient eligibility

About

The independent impact of surgeon volume on outcome of patients undergoing pancreaticoduodenectomy in a high-volume Institution was assessed. A significant reduction of pancreatic fistula rate was found in the high-volume surgeon group in comparison with low-volume surgeon group. However, no difference between groups was found in mortality, major complications, and hospital stay.

Full description

Objectives: To define the independent impact of surgeon volume on outcome after pancreaticoduodenectomy (PD) in a single high-volume institution.

Summary Background Data: The impact of surgeon volume on PD outcome is still controversial. So far, data available are from retrospective multi-institutional reviews, considering in-hospital mortality as the only outcome variable.

Methods: Prospectively collected data on 610 patients who underwent PD from August 2001 to August 2009 were analyzed. Cut-off value to categorize high and low-volume surgeons (HVS and LVS, respectively) was 18 PD/year. Primary endpoint was operative mortality (death within 30-day post-discharge). Secondary endpoints were morbidity, pancreatic fistula (PF) and length of stay. Demographic, clinical, and surgical variables were recorded.

Enrollment: 610 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who underwent pancreaticoduodenectomy between August 2001 and August 2009

Exclusion criteria

• Other type of surgery

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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610 participants in 2 patient groups

High volume surgeons

Active Comparator group

Description:

high volume surgeons performed at least 18 PD/year.

Treatment:

Procedure: Pancreaticoduodenectomy

Low volume surgeons

Active Comparator group

Description:

low volume surgeons performed less than 18 PD/year.

Treatment:

Procedure: Pancreaticoduodenectomy