Frequency with which surgeons undertake pancreaticoduodenectomy determines length of stay, hospital charges, and in-hospital mortality

Rosemurgy, Alexander S.; Bloomston, Mark; Serafini, Francesco; Coon, Bruce; Murr, Michel M.; Carey, Larry C.

doi:10.1016/s1091-255x(01)80009-3

Cited by 90 publications

(64 citation statements)

References 16 publications

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“…During the last few years, several studies have shown that the in-hospital mortality rate for the complex, highrisk pancreatoduodenectomy is lower when performed in high-volume settings than when performed in low-volume settings [8,9,23,37,75,[77][78][79][80][81][82][83], demonstrating that regionalisation could result in a substantial decrease in mortality (table 2). Among 1,972 patients undergoing pancreatoduodenectomy for cancer in New York state between 1984 and 1991, the operative mortality was 22% in minimal-volume and 12% in low-volume hospitals, both substantially higher than the 4% mortality at 2 'high-volume' institutions.…”

Section: Evaluation Of Short-term Results Of Regionalisation Of Pancrmentioning

confidence: 99%

“…From a comparison of 5 different studies [37,[59][60][61][62] focusing on the economic outcome of the Whipple operation (table 1), it can be concluded that despite different definitions of costs and different ways of collecting the data, the average cost during a hospitalisation for a pancreatoduodenectomy was about US$ 1000 per day.…”

Section: Economic Implicationsmentioning

confidence: 99%

“…No other major elective intra-abdominal procedure is associated with such a high morbidity and mortality. It should then also be taken into account that the post-operative complications of pancreatoduodenectomy are alarmingly costly [37,48,49].…”

Section: Introductionmentioning

confidence: 99%

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Resection for pancreatic cancer in the new millennium

Andrén‐Sandberg

Neoptolemos

2002

Pancreatology

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Section: Evaluation Of Short-term Results Of Regionalisation Of Pancrmentioning

confidence: 99%

Section: Economic Implicationsmentioning

confidence: 99%

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Resection for pancreatic cancer in the new millennium

Andrén‐Sandberg

Neoptolemos

2002

Pancreatology

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“…First of all, concentrating kidney transplant in a few high-volume hospitals could not only potentially decrease the quality of care because of work overload, but also reduce the proficiency of the remaining hospitals and their physicians in delivering kidney transplantation. (91,92) Two controlled studies of perinatal regionalization showed no significant improvement in mortality. (93) One recent study by Hamilton et al (58) found that the regionalization of major surgical procedures in Canada had minimal impact on death and readmission rates but showed a significant decline in the length of stay.…”

Section: The Volume-based Policies In Risky Surgeries and Transplantmentioning

confidence: 99%

Higher Volume and Better Outcomes Relationship in Kidney Transplant

Lee¹,

Ts'ao²,

Loong³

2012

Current Concepts in Kidney Transplantation

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“…In some European countries such as the United Kingdom and Germany, centralization of institutes with a system of high-risk surgical procedures has been recommended, but its effects have not yet been analyzed and no precise report has been made [63]. It seems that the overall results are not changed.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Current Status of Surgery for Pancreatic Cancer

et al. 2007

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Background: In Japan the annual incidence of pancreatic cancer has increased over the last decade, but no advancement has been made in the long-term prognosis after resection. The significant differences in the surgical procedures between Western countries and Japan have been discussed. Therefore, an adequate comparison and analysis of the data from Japan, Europe and the USA is required. This review evaluates many important published reports from Japan which influence surgical procedure. Methods: Several important highlights and controversies regarding the concept of surgical treatment and surgical procedure are discussed comparing the results in Japan with those in Western countries. Results: No significant difference in diagnostic strategy using various imaging methods was observed between Japan and Europe. The stage classification for pancreatic cancer by the Japanese Pancreatic Society (JPS) seems to be superior to others, because the results on long-term prognosis after pancreatectomy of cases with pancreatic head cancer, diagnosed as tubular adenocarcinoma, has been arranged logically. Pancreatectomy with extended radical dissection is recommended in Japan, but several clinical studies from Europe and the USA suggest that this is ineffective. The basic concepts of this controversy have recently come closer altogether. Scientific clinical trials for instance on the necessity of adjuvant treatment, etc., are now on-going. Conclusion: The characteristics on diagnosis and treatment of pancreatic cancer in Japan are described. The JPS registration system for pancreatic cancer can provide much more information, i.e. dependency on diagnostic methods, highly frequent sites of lymph node and of distant metastases, the prognosis of small pancreatic cancers, etc. The indication for any surgical treatments should be limited to cases with the possibility of cancer free margins.

show abstract

Frequency with which surgeons undertake pancreaticoduodenectomy determines length of stay, hospital charges, and in-hospital mortality

Cited by 90 publications

References 16 publications

Resection for pancreatic cancer in the new millennium

Resection for pancreatic cancer in the new millennium

Higher Volume and Better Outcomes Relationship in Kidney Transplant

Current Status of Surgery for Pancreatic Cancer

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