title: Assessment of Outcome After Pancreaticoduodenectomy by Junior Surgeons.
abstract: OBJECTIVE
  Pancreaticoduodenectomy (PD) is one of the most complicated procedures. We retrospectively assessed the therapeutic outcome after PD by Junior surgeons.
  
  
  METHODS
  This study included 253 patients. We retrospectively analyzed surgical outcomes and long-term survivals of PDs performed by Junior surgeons (surgical training year within 10 years) as compared to those by Senior surgeons (surgical training year over 10 years).
  
  
  RESULTS
  Operative time was significantly longer in junior surgeons than that in Senior surgeons (p<0.001). Intraoperative blood loss (p=0.079), hospital stay (p=0.803), complications (p=0.700), mortality (p=0.442) were comparable between the two groups. Disease-free and overall survival rates were not statistically different between the two groups in pancreatic cancer (p=0.248 and p=0.526) and in bile duct or ampullary cancer (p=0.873 and p=0.954).
  
  
  CONCLUSIONS
  PD performed by Junior surgeons require approximately 70 more minutes but surgery can be performed safely under appropriate patient selection, intraoperative supervision and perioperative management with comparable long-term survival.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan shirai@jikei.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shirai
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Horiuchi
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan Division of Gene Therapy, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Saito
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gocho
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000193:education; D012189:Retrospective Studies; D066231:Surgeons; D016896:Treatment Outcome
keywords: Pancreatoduodenectomy; biliary cancer; learning curve; pancreatic cancer; young surgeons