title: Instruction of expert surgeon secures favorable outcomes after standard pancreaticoduodenectomy performed by less experienced surgeons.
abstract: OBJECTIVE
  We investigated the factors associated with a favorable outcome after standard pancreaticoduodenectomy (PD) performed by the less experienced surgeon under expert supervision in a high-volume hospital of PD.
  
  
  METHODS
  Between April 2009 and March 2013, 139 PDs were performed in our hospital, and among them 99 PDs were standard fashion. Two expert surgeons performed 57 of 99 PDs, and the cases were assigned as Group A. Forty-two of 99 PDs were performed by 5 less experienced surgeons under the instruction of expert surgeons, and the cases were assigned as Group B. We compared the intraoperative outcomes and postoperative major complications and mortality between two groups.
  
  
  RESULTS
  There was no hospital death in Group B, but one in Group A (1.8%), and the overall mortality rate of 99 patients in this series was 1.0%. In comparison of postoperative major complications, there was no significant difference in the frequencies of patients with all postoperative major complications (Group A; 43.9% vs. Group B 33.3%).
  
  
  CONCLUSIONS
  Outcomes after standard PD performed by less experienced surgeons were favorable. The instruction of expert surgeon in a high volume hospital may secure a favorable outcome after standard PD.
authors.forename: Nao
authors.initials: N
authors.lastname: Kakizawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Noda
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Watanabe
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Takaharu
authors.initials: T
authors.lastname: Kato
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ichida
authors.forename: Toshiki
authors.initials: T
authors.lastname: Rikiyama
mesh_terms: D000368:Aged; D002983:Clinical Competence; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D016577:Pancreaticoduodenectomy / Q000193:education* / Q000592:standards*