The impact of surgical experience and frequency of practice on perioperative outcomes in pancreatic surgery

Krautz C, Haase E, Elshafei M, Saeger HD, Distler M, Grützmann R, Weber G (2019)


Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 19

Article Number: 108

Journal Issue: 1

DOI: 10.1186/s12893-019-0577-6

Abstract

Objective: We aimed to determine the impact of surgical experience and frequency of practice on perioperative morbidity and mortality in pancreatic surgery. Methods: 1281 patients that underwent pancreatic resections from 1993 to 2013 were retrospectively analyzed using logistic regression models. All cases were stratified according to the surgeon's level of experience, which was based on the number of previously performed pancreatic resections and the extent of received supervision (novice: N < 20/intensive; intermediate: N = 21-90/decreasing; and experienced surgeon: N > 90/none). Additional stratification was based on the frequency of practice (sporadic: 3 resections > 6 weeks, frequent: 3 resections ≤6 weeks). Results: The novice and experienced categories were related to a decreased risk of postoperative pancreatic fistulas (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.26-0.82 and 0.54, 95% CI 0.36-0.82) and in-hospital mortality (OR 0.45, 95% CI 0.17-1.16 and 0.42, 95% CI 0.21-0.83) compared to the intermediate category. Frequent practice was associated with a significantly lower risk of delayed gastric emptying (OR 0.56, 95% CI 0.38-0.83), postpancreatectomy hemorrhage (OR 0.64, 95% CI 0.42-0.98) and in-hospital mortality (OR 0.45, 95% CI 0.24-0.87). Conclusions: Our results emphasize the importance of supervision within a pancreatic surgery training program. In addition, our data underline the need of a sufficient patient caseload to ensure frequent practice.

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APA:

Krautz, C., Haase, E., Elshafei, M., Saeger, H.D., Distler, M., Grützmann, R., & Weber, G. (2019). The impact of surgical experience and frequency of practice on perioperative outcomes in pancreatic surgery. BMC Surgery, 19(1). https://dx.doi.org/10.1186/s12893-019-0577-6

MLA:

Krautz, Christian, et al. "The impact of surgical experience and frequency of practice on perioperative outcomes in pancreatic surgery." BMC Surgery 19.1 (2019).

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