In:
Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 30, No. 1 ( 2023-01), p. 60-71
Abstract:
To ensure that highly advanced hepatobiliary‐pancreatic surgery (HBPS) is performed safely, the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery (JSHBPS) board certification system for expert surgeons established a safety committee to monitor surgical safety. Methods We investigated postoperative mortality rates based on summary reports of numbers and outcomes of highly advanced HBPS submitted annually by the board‐certified training institutions from 2012 to 2019. We also analyzed summary reports on mortality cases submitted by institutions with high 90‐day post‐HBPS mortality rates and recommended site visits and surveys as necessary. Results Highly advanced HBPS was performed in 121 518 patients during the 8‐year period. Thirty‐day mortality rates from 2012 to 2019 were 0.92%, 0.8%, 0.61%, 0.63%, 0.70%, 0.59%, 0.48%, and 0.52%, respectively ( P 〈 .001). Ninety‐day mortality rates were 2.1%, 1.82%, 1.62%, 1.28%, 1.46%, 1.22%, 1.19%, and 0.98%, respectively ( P 〈 .001). Summary reports were submitted by 20 hospitals between 2015 and 2019. Mortality rates before and after the start of report submission and audit were 5.72% and 2.79%, respectively (odds ratio 0.690, 95% confidence interval 0.487‐0.977; P = .037). Conclusions Development of a system for designation of board‐certified expert surgeons and safety management improved the mortality rate associated with highly advanced HBPS.
Type of Medium:
Online Resource
ISSN:
1868-6974
,
1868-6982
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
2536390-6
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