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  • High-volume surgeons vs hig...
    Toomey, Paul G., M.D; Teta, Anthony F., B.S; Patel, Krishen D., B.S; Ross, Sharona B., M.D; Rosemurgy, Alexander S., M.D

    The American journal of surgery, 2016, January 2016, 2016-Jan, 2016-01-00, 20160101, Letnik: 211, Številka: 1
    Journal Article

    Abstract Background High-volume hospitals are purported to provide “best” outcomes. We undertook this study to evaluate the outcomes after pancreaticoduodenectomy when high-volume surgeons relocate to a low-volume hospital (ie, no pancreaticoduodenectomies in >5 years). Methods Outcomes after the last 50 pancreaticoduodenectomies undertaken at a high-volume hospital in 2012 (ie, before relocation) were compared with the outcomes after the first 50 pancreaticoduodenectomies undertaken at a low-volume hospital (ie, after relocation) in 2012 to 2013. Results Patients undergoing pancreaticoduodenectomies at a high-volume vs a low-volume hospital were not different by age or sex. Patients who underwent pancreaticoduodenectomy at the low-volume hospital had shorter operations with less blood loss, spent less time in the intensive care unit, and had shorter length of stay ( P < .05 for each); 30-day mortality and 30-day readmission rates were not different. Conclusions The salutary benefits of undertaking pancreaticoduodenectomy at a high-volume hospital are transferred to a low-volume hospital when high-volume surgeons relocate. The “best” results follow high-volume surgeons.