Impact of hospital volume on in-hospital mortality in pancreatic surgery.

Pancreaticoduodenectomy, mostly performed for pancreatic cancer, has been associated with considerable morbidity rates (40%-60%) and mortality rates (20%-30%). Even after resection, the prognosis is poor, and as a result some physicians have kept a nihilistic approach; Gudjonsson concluded in his review that pancreatic resections are a waste of resources. During the last decade, mortality rates have decreased dramatically to less than 5% in centers with experience, and have led to a more optimistic view in favor of resection.