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Related Experiment Video

Updated: Jul 16, 2026

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy

Published on: March 17, 2026

The learning curve in pancreatic surgery.

Jennifer F Tseng¹, Peter W T Pisters, Jeffrey E Lee

¹Department of Surgery and the UMass Memorial Cancer Center, University of Massachusetts Medical School, Worcester, Mass, USA. tsengj@ummhc.org

|March 27, 2007

Summary

Surgeons show a learning curve in pancreaticoduodenectomy. After 60 cases, operative time, blood loss, and hospital stay significantly decreased, with improved margin-negative resections for pancreatic cancer.

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Technical Detail for Robot Assisted Pancreaticoduodenectomy

Technical Detail for Robot Assisted Pancreaticoduodenectomy

Published on: September 28, 2019

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Last Updated: Jul 16, 2026

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy

Published on: March 17, 2026

Technical Detail for Robot Assisted Pancreaticoduodenectomy

Technical Detail for Robot Assisted Pancreaticoduodenectomy

Published on: September 28, 2019

Area of Science:

Surgical Oncology
Gastrointestinal Surgery
Medical Education

Background:

Pancreaticoduodenectomy is a complex surgical procedure.
A learning curve for pancreaticoduodenectomy is hypothesized, even for trained surgeons.

Purpose of the Study:

To investigate the existence and impact of a learning curve in pancreaticoduodenectomy.
To analyze the effect of surgical experience on patient outcomes and resection margin status.

Main Methods:

A retrospective study of 650 pancreaticoduodenectomy cases performed by 3 surgeons between 1990 and 2004.
Analysis of operative time, estimated blood loss (EBL), length of hospital stay (LOS), and resection margin status.
Statistical analysis using chi-squared, independent t test, and Mann-Whitney U test; trends modeled using polynomial equations.

Main Results:

Significant reductions in EBL (1100 vs 725 mL), operative time (589 vs 513 min), and LOS (15 vs 13 days) were observed from the first 60 to the second 60 cases per surgeon.
Microscopically positive or suspicious margins decreased from 30% to 8% after the initial 60 cases.
Further incremental improvements were noted with continued surgical experience.

Conclusions:

Pancreaticoduodenectomy demonstrates an inherent learning curve.
Surgeons achieve improved outcomes, including reduced EBL, operative time, LOS, and increased margin-negative resections, after approximately 60 cases.
Surgical performance continues to improve throughout an operative career.