Early perioperative outcomes and pancreaticoduodenectomy in a general surgery residency training program. J Gastrointest Surg 2006 Apr;10(4):478-82
Date
04/22/2006Pubmed ID
16627211DOI
10.1016/j.gassur.2006.01.010Scopus ID
2-s2.0-33646483962 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
Current trends in national health care are triggering a reassessment of training in general surgery. Currently, 75% of general surgery residents seek postgraduate fellowship training, and significant debate has occurred regarding the best manner for surgeons to acquire competency in performing complex operations. Pancreaticoduodenectomy (PD) is a complex procedure performed infrequently by most surgical graduates. From 1990 through 1997, the average number of PD operations performed per general surgery graduate ranged from 1.5 to 2.5. We examine the surgical outcomes following PD performed by surgical resident staff in a university-based general surgery training program. Between January 2001 and October 2004, 164 patients underwent PD for periampullary disease. Data were prospectively entered into a computerized database, including resident participation. We analyzed 30-day mortality and morbidity rates. Perioperative outcomes were 30-day mortality (2.2%), pancreatic fistula (6.1%), reoperation (2.2%), average length of hospital stay (13.5 days), mean operating time (489 minutes), and median estimated blood loss (1274 ml per case). PD can be performed with an acceptable morbidity and mortality within the teaching structure of a general surgery training program. These outcomes are likely related to the performance of PD at a high-volume, tertiary center by a single surgeon and compare favorably to best-practice benchmark outcomes.
Author List
Fischer CP, Hong JCMESH terms used to index this publication - Major topics in bold
AdenocarcinomaAdult
Aged
Aged, 80 and over
Benchmarking
Blood Loss, Surgical
Cause of Death
Female
Gastric Emptying
General Surgery
Humans
Internship and Residency
Length of Stay
Male
Middle Aged
Pancreatic Fistula
Pancreatic Neoplasms
Pancreaticoduodenectomy
Pancreatitis
Postoperative Complications
Prospective Studies
Reoperation
Time Factors
Treatment Outcome
