[Performing major upper abdominal operations in a low-volume hospital: is it possible?].
BACKGROUND
The outcomes of cardio-oesophageal resection, gastric resection, total gastrectomy and Whipple's operation in a low-volume hospital over a decade are presented.


METHODS
Thirty-seven patients were followed for five years after a cardio-oesophageal resection, 21 after a Billroth II resection, 15 after total gastrectomy and 28 after a Whipple's operation. Mortality and morbidity rates, post-operative in-hospital period and long-term survival were measured.


RESULTS
Cardio-oesophageal resection: The morbidity rate was 19%, the mortality rate was 11%, and the median post-operative stay in hospital was 11 days. The five-year survival rate based on death from cancer was 37% and from all causes 32%. Gastric resection and gastrectomy: The morbidity rate was 14%, the mortality rate was 3%, and the median post-operative period in hospital was 9 days after gastric resection and 11 days after gastrectomy. The five-year survival rate based on death from was cancer 55% and from all causes 37%. Whipple's procedure: The morbidity rate was 17%, the mortality rate was 4% and the median post-operative stay in hospital was 10 days. The survival rate based on death from cancer was 77% and from all causes was 54% after five years for cancer of the ampulla of Vater, and 27% and 31% after three years for pancreatic head carcinoma.


CONCLUSIONS
Major gastric and pancreatic operations can be performed in a low-volume hospital with satisfactory results.
Kiil
Jørgen
J
Viborg Sygehus, Organkirurgisk Afdeling, Afsnit for Kirurgi og Karkirurgi, Viborg. joergenkiil@dadlnet.dk
Henneberg
Eskild W
EW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia / Q000601:surgery; D002983:Clinical Competence; D003718:Denmark / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality / Q000592:standards; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006276:Health Facility Size; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D013274:Stomach Neoplasms / Q000601:surgery*; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome