title: The quality control in pancreatic surgery.
abstract: OBJECTIVE
  Over the past decade, several centralization programs for major pancreatic surgery have been implemented in hospitals with high procedural volumes. Although the impact of this process was altogether positive, also possible negative effects have been evidenced, above all the lack of comprehensive coverage and access to specialized centers. In order to solve these problems, it was proposed the utilization of an outcome-based and not volume-based center selection. For this purpose the choice of an appropriate outcome assessment system is crucial.
  
  
  METHODS
  We retrospectively reviewed 74 patients undergoing pancreatoduodenectomy. The outcomes were evaluated utilizing the Accordion Severity Classification of Postoperative Complications.
  
  
  RESULTS
  The morbidity of 58 % and the mortality of 4 % were comparable with the ones reported in large series utilizing the same classification system.
  
  
  CONCLUSIONS
  The Accordion system is an effective method of quality control for pancreatic surgery both in high- and low-volume hospitals.
authors: Chiara
authors: C
authors: Dobrinja
authors: Monica
authors: M
authors: Urbani
authors: Mauro
authors: M
authors: Roseano
authors: Gennaro
authors: G
authors: Liguori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016577:Pancreaticoduodenectomy / Q000592:standards*; D011786:Quality Control; D012189:Retrospective Studies