BACKGROUND AND AIM OF THE STUDY: Complications of pancreatic resections are dangerous and costly. A literature review was therefore done to investigate the evidence for improving the results by regionalizing this demanding surgery. RESULTS: Studies from four countries (USA, UK, the Netherlands and Finland) with advanced health care systems have shown a significant inverse correlation between case volume for pancreatic cancer resection and post-operative mortality. Further analysis reveals lower complications, reduced hospital stay, reduced hospital costs and improved survival of patients treated in high-volume hospitals. The relationship volume and outcome is with institutional volume rather than single surgeon caseload. The evidence therefore strongly supports the regionalization of pancreatic cancer surgery into large specialized multi-disciplinary units. In the UK, the National Health Service Executive has instructed Regional Health Authorities to concentrate pancreatic cancer surgery into designated Regional Centres ideally with catchment populations of 2-4 million. There is now considerable pressure to adopt a similar policy in all countries with advanced health care systems. CONCLUSION: There is today enough evidence to advocate the regionalization of pancreatic cancer resections. Copyright 2002 S. Karger AG, Basel and IAP
BACKGROUND AND AIM OF THE STUDY: Complications of pancreatic resections are dangerous and costly. A literature review was therefore done to investigate the evidence for improving the results by regionalizing this demanding surgery. RESULTS: Studies from four countries (USA, UK, the Netherlands and Finland) with advanced health care systems have shown a significant inverse correlation between case volume for pancreatic cancer resection and post-operative mortality. Further analysis reveals lower complications, reduced hospital stay, reduced hospital costs and improved survival of patients treated in high-volume hospitals. The relationship volume and outcome is with institutional volume rather than single surgeon caseload. The evidence therefore strongly supports the regionalization of pancreatic cancer surgery into large specialized multi-disciplinary units. In the UK, the National Health Service Executive has instructed Regional Health Authorities to concentrate pancreatic cancer surgery into designated Regional Centres ideally with catchment populations of 2-4 million. There is now considerable pressure to adopt a similar policy in all countries with advanced health care systems. CONCLUSION: There is today enough evidence to advocate the regionalization of pancreatic cancer resections. Copyright 2002 S. Karger AG, Basel and IAP
Authors: J G Williams; S E Roberts; M F Ali; W Y Cheung; D R Cohen; G Demery; A Edwards; M Greer; M D Hellier; H A Hutchings; B Ip; M F Longo; I T Russell; H A Snooks; J C Williams Journal: Gut Date: 2007-02 Impact factor: 23.059
Authors: Katharina Marsoner; Johannes Haybaeck; Dora Csengeri; James Elvis Waha; Jakob Schagerl; Rainer Langeder; Hans Joerg Mischinger; Peter Kornprat Journal: BMC Cancer Date: 2016-11-04 Impact factor: 4.430
Authors: Marius Distler; Felix Rückert; Maximilian Hunger; Stephan Kersting; Christian Pilarsky; Hans-Detlev Saeger; Robert Grützmann Journal: BMC Surg Date: 2013-04-22 Impact factor: 2.102
Authors: Katharina Marsoner; Rainer Langeder; Dora Csengeri; Gottfried Sodeck; Hans Jörg Mischinger; Peter Kornprat Journal: Wien Klin Wochenschr Date: 2016-06-30 Impact factor: 1.704