[Morbidity and mortality rates in relation to the "surgeon factor" after duodenopancreatectomy].
OBJECTIVE
The present study was designed to determine whether the surgeon factor has an independent effect on morbidity and mortality rates after duodenopancreatectomy.


METHODS
Between October 2002 and December 2006, we performed a study of 119 patients who underwent duodenopancreatectomy. The surgeons were divided into 3 groups according to the number of interventions they performed each year: a low volume group (three Whipple procedures per year), a medium volume group (four to 10 Whipple procedures per year) and a high volume group (> 10 Whipple procedures per year).


RESULTS
The morbidity rate was higher in the low volume group (82%) than in the high volume group (35%). Length of hospital stay was clearly longer in the low and medium volume groups (27 days, and 21 days) than in the high volume group (17 days). Comparison of the results of the 3 groups revealed that the group performing three or less interventions per year (low volume) had the highest mortality rate (47%), while the group performing more than 10 interventions per year (high volume) had a very low mortality rate (4%).


CONCLUSIONS
We found that the volume-to-surgeon ratio was inversely proportional to morbidity, length of hospital stay, return to oral intake, and mortality rates. Therefore, increasing surgical volume could improve morbidity and mortality rates.
Targarona
Javier
J
Servicio 3AII Cirugía de Hígado, Vías Biliares y Páncreas, Unidad de Pancreatitis Aguda Grave, Departamento de Cirugía General, Hospital Nacional Edgardo Rebagliati Martins, Clínica Anglo Americana, Lima, Perú. jtargaronam@viabcp.com
Pando
Elizabeth
E
Garatea
Rafael
R
Vavoulis
Alexandra
A
Montoya
Eduardo
E
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*