title: Safety-related outcomes of the Japanese Society of Hepato-Biliary-Pancreatic Surgery board certification system for expert surgeons.
abstract: BACKGROUND
  We investigated safety-related outcomes of hepatobiliary pancreatic (HBP) surgeries performed after establishment of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons.
  
  
  METHODS
  We analyzed post-HBP surgery mortality data obtained from annual safety reports provided by board-certified training institutions between 2012 and 2015.
  
  
  RESULTS
  The 90-day mortality rate for the 53,929 high-level HBP surgeries performed at board-certified training institutions was 1.7%. The 30-day mortality rates for 2012, 2013, 2014, and 2015 were 0.9%, 0.7%, 0.6%, and 0.6%, respectively, and the 90-day mortality rates were 2.1%, 1.8%, 1.6%, and 1.3%, respectively, with significant decreases in both. The surgeries with high 4-year cumulative mortality rates were left hepatic trisectionectomy (10.3%), hepatopancreatectomy (7.6%), liver transplant recipient surgery (6.7%), hepatectomy with extrahepatic bile duct resection (4.6%), and right hepatic trisectionectomy (4.5%). Over the 4-year period, the number of operations increased, but the 90-day mortality rates for these surgeries, with the exception of right trisectionectomy, decreased.
  
  
  CONCLUSIONS
  The JSHBPS board certification system for expert surgeons has significantly decreased mortality subsequent to high-level HBP surgeries. Reducing mortality associated with high-risk HBP surgeries will be our next challenge.
authors.affiliation: Member of the JSHBPS board of director in charge of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Otsubo
authors.affiliation: Members of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Members of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Sano
authors.affiliation: Members of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.affiliation: Members of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Ota
authors.affiliation: Members of the JSHBPS Safety Management Committee, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Katagiri
authors.affiliation: Members of the JSHBPS Board of Directors and of the JSHBPS Board Certification System Committee, Tokyo, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
authors.affiliation: Members of the JSHBPS Board of Directors and of the JSHBPS Board Certification System Committee, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.affiliation: Members of the JSHBPS Board of Directors and of the JSHBPS Board Certification System Committee, Tokyo, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.affiliation: Members of the JSHBPS Board of Directors and of the JSHBPS Board Certification System Committee, Tokyo, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.affiliation: Members of the JSHBPS Board of Directors and of the JSHBPS Board Certification System Committee, Tokyo, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
authors.affiliation: Supervisor of the JSHBPS Secretariat, Tokyo, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.affiliation: Honorary President of the JSHBPS, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: President of the JSHBPS, Tokyo, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D001660:Biliary Tract Diseases / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000193:education*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012955:Societies, Medical; D013044:Specialty Boards; D066231:Surgeons / Q000193:education / Q000592:standards*; D015996:Survival Rate / Q000639:trends
keywords: Board certification; Hepatobiliary pancreatic surgery; High-volume center; Mortality; Safety