BACKGROUND: Participation by surgical trainees in complex procedures is key to their development as future practicing surgeons. The impact of surgical fellows versus general surgery resident assistance on outcomes in pancreatoduodenectomy (PD) has not been well studied. The purpose of this study was to determine differences in patient outcomes based on level of surgical trainee. METHODS: Consecutive cases of PD (n = 254) were reviewed at a single high-volume institution over a 2-year period (July 2013-June 2015). Thirty-day outcomes were monitored through the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) and Quality In-Training Initiative. Patient outcomes were compared between PD assisted by general surgery residents versus hepatopancreatobiliary fellows. RESULTS: The hepatopancreatobiliary surgery fellows and general surgery residents participated in 109 and 145 PDs, respectively. The incidence of each individual postoperative complication (renal, infectious, pancreatectomy-specific, and cardiopulmonary), total morbidity, mortality, and failure to rescue were the same between groups. CONCLUSIONS: Patient operative outcomes were the same between fellow- and resident-assisted PD. These results suggest that hepatopancreatobiliary surgery fellows and general surgery residents should be offered the same opportunities to participate in complex general surgery procedures.
BACKGROUND: Participation by surgical trainees in complex procedures is key to their development as future practicing surgeons. The impact of surgical fellows versus general surgery resident assistance on outcomes in pancreatoduodenectomy (PD) has not been well studied. The purpose of this study was to determine differences in patient outcomes based on level of surgical trainee. METHODS: Consecutive cases of PD (n = 254) were reviewed at a single high-volume institution over a 2-year period (July 2013-June 2015). Thirty-day outcomes were monitored through the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) and Quality In-Training Initiative. Patient outcomes were compared between PD assisted by general surgery residents versus hepatopancreatobiliary fellows. RESULTS: The hepatopancreatobiliary surgery fellows and general surgery residents participated in 109 and 145 PDs, respectively. The incidence of each individual postoperative complication (renal, infectious, pancreatectomy-specific, and cardiopulmonary), total morbidity, mortality, and failure to rescue were the same between groups. CONCLUSIONS:Patient operative outcomes were the same between fellow- and resident-assisted PD. These results suggest that hepatopancreatobiliary surgery fellows and general surgery residents should be offered the same opportunities to participate in complex general surgery procedures.
Authors: Antoine N Saliba; Ali T Taher; Hani Tamim; Afif R Harb; Aurelie Mailhac; Amr Radwan; Faek R Jamali Journal: J Am Coll Surg Date: 2015-10-27 Impact factor: 6.113
Authors: Rachel R Kelz; Morgan M Sellers; Caroline E Reinke; Rachel L Medbery; Jon Morris; Clifford Ko Journal: J Am Coll Surg Date: 2013-12 Impact factor: 6.113
Authors: Robert W Krell; Nancy J O Birkmeyer; Bradley N Reames; Arthur M Carlin; John D Birkmeyer; Jonathan F Finks Journal: J Am Coll Surg Date: 2013-10-29 Impact factor: 6.113
Authors: Mark Wilkiemeyer; Theodore N Pappas; Anita Giobbie-Hurder; Kamal M F Itani; Olga Jonasson; Leigh A Neumayer Journal: Ann Surg Date: 2005-06 Impact factor: 12.969
Authors: Carolyn D Seib; David Y Greenblatt; Michael J Campbell; Wen T Shen; Jessica E Gosnell; Orlo H Clark; Quan-Yang Duh Journal: J Am Coll Surg Date: 2014-03-18 Impact factor: 6.113
Authors: Daniel M Relles; Richard A Burkhart; Michael J Pucci; Jocelyn Sendecki; Renee Tholey; Ross Drueding; Patricia K Sauter; Eugene P Kennedy; Jordan M Winter; Harish Lavu; Charles J Yeo Journal: J Gastrointest Surg Date: 2013-11-13 Impact factor: 3.452
Authors: Donald K Groves; Maria S Altieri; Brianne Sullivan; Jie Yang; Mark A Talamini; Aurora D Pryor Journal: J Gastrointest Surg Date: 2018-07-06 Impact factor: 3.452
Authors: Tarik K Yuce; Amy Holmstrom; Nathaniel J Soper; Alexander P Nagle; Eric S Hungness; Ryan P Merkow; Ezra N Teitelbaum Journal: J Gastrointest Surg Date: 2020-09-15 Impact factor: 3.267