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Letter to Editor Reply to: “Centralization of Pancreatic Surgery in Europe: an Update”

Published on Nov 1, 2019in Journal of Gastrointestinal Surgery2.686
· DOI :10.1007/s11605-019-04387-7
Faik G. Uzunoglu11
Estimated H-index: 11
,
Asmus Heumann4
Estimated H-index: 4
+ 1 AuthorsJakob R. Izbicki63
Estimated H-index: 63
Abstract
  • References (8)
  • Citations (0)
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References8
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Background The objective of this article is a review and an analysis of the current state of centralization of pancreatic surgery in Europe. Numerous recent publications demonstrate higher postoperative in-hospital mortality rates in low-volume clinics after pancreatic resection than previously assumed due to their not publishing significantly worse outcomes when compared to high-volume centres. Although the benefits of centralization of pancreatic surgery in high-volume centres have been demons...
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#1Linn Såve NymoH-Index: 4
#2Kjetil Søreide (University of Bergen)H-Index: 40
Last. Kristoffer Lassen (Oslo University Hospital)H-Index: 22
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Abstract Background Centralization of pancreatic resections is advocated due to a volume-outcome association. Pancreatic surgery is in Norway currently performed only in five teaching hospitals. The aim was to describe the short-term outcomes after pancreatoduodenectomy (PD) within the current organizational model and to assess for regional disparities. Methods All patients who underwent PD in Norway between 2012 and 2016 were identified. Mortality (90 days) and relaparotomy (30 days) were asses...
6 CitationsSource
#1René VonlanthenH-Index: 9
#2P. LodgeH-Index: 7
Last. P.-A. ClavienH-Index: 97
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Objectives:To critically assess centralization policies for highly specialized surgeries in Europe and North America and propose recommendations.Background/Methods:Most countries are increasingly forced to maintain quality medicine at a reasonable cost. An all-inclusive perspective, including health
14 CitationsSource
#2Maurice J. ZwartH-Index: 3
Last. Peter P. CoeneH-Index: 6
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Abstract Background In the mandatory nationwide Dutch Pancreatic Cancer Audit, rates of major complications and Failure to Rescue (FTR) after pancreatoduodenectomy between low- and high-mortality hospitals are compared, and independent predictors for FTR investigated. Methods Patients undergoing pancreatoduodenectomy in 2014 and 2015 in The Netherlands were included. Hospitals were divided into quartiles based on mortality rates. The rate of major complications (Clavien-Dindo ≥3) and death after...
17 CitationsSource
#1Marco StellaH-Index: 1
Last. Alessandro ArriciatiH-Index: 1
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Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume–outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon’s experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by ...
2 CitationsSource
#1Maryam Derogar (KI: Karolinska Institutet)H-Index: 11
#2J. Blomberg (KI: Karolinska Institutet)H-Index: 1
Last. O. Sadr-Azodi (Uppsala University)H-Index: 1
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Background The association between hospital teaching status and mortality after pancreatic resection is not well explored. Although hospital volume is related to short-term mortality, the effect on long-term survival needs investigation, taking into account hospital teaching status and selective referral patterns. Methods This was a nationwide retrospective register-based cohort study of patients undergoing pancreatic resection between 1990 and 2010. Follow-up for survival was carried out until ...
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#1Jennifer F. Tseng (UMMS: University of Massachusetts Medical School)H-Index: 37
#2Peter W. T. PistersH-Index: 43
Last. Douglas B. Evans (University of Texas MD Anderson Cancer Center)H-Index: 92
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93 CitationsSource
#1Jennifer F. Tseng (UMMS: University of Massachusetts Medical School)H-Index: 37
#2Peter W.T. Pisters (University of Texas MD Anderson Cancer Center)H-Index: 65
Last. Douglas B. Evans (University of Texas MD Anderson Cancer Center)H-Index: 92
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Background Pancreatic surgery is technically complex. We hypothesized that a learning curve existed for pancreaticoduodenectomy even for surgeons who had completed their training. Methods During 1990 to 2004, we studied 650 consecutive patients who underwent pancreaticoduodenectomy by 3 surgeons who began their attending careers at 1 center. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), and the status of resection margins (for pancreatic adenocarcinoma) were analyzed...
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