One hundred and seventy-eight consecutive pancreatoduodenectomies without mortality: role of the multidisciplinary approach

Samra, Jaswinder S.; Bachmann, Raúl Alvarado; Choi, Julian; Gill, Anthony J.; Neale, Michael; Puttaswamy, Vikram; Bell, Catherine; Norton, Ian D.; Cho, Sarah; Blome, Steven; Maher, Richard; Gananadha, Sivakumar; Hugh, Thomas J.

doi:10.1016/s1499-3872(11)60070-2

Cited by 28 publications

(19 citation statements)

References 43 publications

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“…LOS post‐PD was similar between hospital peer groups and individual hospitals. The median of 15 days (range 12–21 days) was similar to that reported in other Australian studies and the 9–21 days reported for high volume hospitals in Germany and the USA …”

Section: Discussionsupporting

confidence: 87%

Short‐term outcomes of pancreaticoduodenectomy in the state of Victoria: hospital resources are more important than volume

Stevens

Watters

2019

ANZ Journal of Surgery

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Background Pancreaticoduodenectomy (PD) is a high‐risk procedure. Australian hospitals perform a relatively low volume of PD. This study sought to gain an understanding of hospital volume and short‐term outcomes of the procedure in the Australian state of Victoria. Methods The Dr Foster Quality Investigator tool was used to interrogate the Victorian Admitted Episodes Database for the Australian Classification of Health Intervention code for PD (30584) from July 2010 to June 2016. The data set included patients from a peer group of 14 hospitals that included all the public hospitals performing PD during this period. Patient characteristics, inpatient mortality, 30‐day readmission rates and median length of stay were reported for each de‐identified hospital. Results There were 547 PD conducted over 6 years in 10 public hospitals. The median patient age was 65 years. Inpatient mortality was 2.7%. There was a significant risk adjusted difference in mortality between principal referral and other public hospitals. Annual hospital volume ranged from 3 to 20 PD, and there was no significant relationship between mortality, readmission rates or length of stay and hospital volume. Conclusion The inpatient mortality associated with PD in Victorian public hospitals is comparable to that seen in overseas studies. While hospital volume is relatively low, there does not seem to be a relationship between volume and short‐term outcomes. Variability between hospital peer groups suggests that resource availability is more important than volume. The development of a procedure specific registry would be useful to test the outcomes of this study and determine long‐term PD outcomes.

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Section: Discussionsupporting

confidence: 87%

Short‐term outcomes of pancreaticoduodenectomy in the state of Victoria: hospital resources are more important than volume

Stevens

Watters

2019

ANZ Journal of Surgery

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“…By now, PD has become the standard and the only curative treatment available for periampullary malignant tumors. Despite the advances in surgical techniques and in the pre‐ and postoperative care available in specialized centers over the last two decades, PD is still associated with a 40% morbidity rate 1, 2, 19, 20. The major surgical complications are POPF, hemorrhage, abscess, and DGE.…”

Section: Discussionmentioning

confidence: 99%

A Modified Technique of End‐to‐End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures

Wang

Zhu

Wang

et al. 2013

Journal of Surgical Oncology

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“…The development of collaborative clinical networks in rare or complex conditions has assisted in disease diagnosis and classification (Mehta et al, 2007) and the development of investigation and management algorithms (Samra et al, 2011), and facilitates collection, analysis and dissemination of data (Breslin et al, 2011). Regardless of the membership, the principles of collaborative services remain much the same.…”

Section: Multicenter Collaborative Service Modelsmentioning

confidence: 99%

Balancing Patient Access to Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome With Maintaining Procedural Competence: Are Collaborative Services Part of the Solution?

et al. 2016

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The benefits of fetoscopic laser photocoagulation (FLP) for treatment of twin-to-twin transfusion syndrome (TTTS) have been recognized for over a decade, yet access to FLP remains limited in many settings. This means at a population level, the potential benefits of FLP for TTTS are far from being fully realized. In part, this is because there are many centers where the case volume is relatively low. This creates an inevitable tension; on one hand, wanting FLP to be readily accessible to all women who may need it, yet on the other, needing to ensure that a high degree of procedural competence is maintained. Some of the solutions to these apparently competing priorities may be found in novel training solutions to achieve, and maintain, procedural proficiency, and with the increased utilization of 'competence based' assessment and credentialing frameworks. We suggest an under-utilized approach is the development of collaborative surgical services, where pooling of personnel and resources can improve timely access to surgery, improve standardized assessment and management of TTTS, minimize the impact of the surgical learning curve, and facilitate audit, education, and research. When deciding which centers should offer laser for TTTS and how we decide, we propose some solutions from a collaborative model.

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One hundred and seventy-eight consecutive pancreatoduodenectomies without mortality: role of the multidisciplinary approach

Cited by 28 publications

References 43 publications

Short‐term outcomes of pancreaticoduodenectomy in the state of Victoria: hospital resources are more important than volume

Short‐term outcomes of pancreaticoduodenectomy in the state of Victoria: hospital resources are more important than volume

A Modified Technique of End‐to‐End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures

Balancing Patient Access to Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome With Maintaining Procedural Competence: Are Collaborative Services Part of the Solution?

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