[Pancreatoduodenectomy: learning curve within single multi-field center].

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Medical Education

Background:

• Pancreatoduodenectomy is a complex abdominal surgery with a significant learning curve.
• Outcomes can vary based on surgeon experience and institutional learning curves.

Purpose of the Study:

• To analyze the learning curve associated with pancreatoduodenectomy using immediate surgical outcomes.
• To assess the impact of cumulative experience on key surgical performance indicators.

Main Methods:

• A retrospective analysis of 120 pancreatoduodenectomies performed between 2010-2016.
• Patients were divided into two groups: the first 60 procedures (Group A) and the subsequent 60 procedures (Group B).
• Comparison of intraoperative blood loss, surgery time, postoperative hospital stay, and R0 resection rates between the groups.

Main Results:

• Significant reductions in intraoperative blood loss (1100 ml vs. 725 ml), surgery time (589 min vs. 513 min), and postoperative hospital stay (15 days vs. 13 days) were observed from Group A to Group B.
• The incidence of achieving a negative resection margin (R0) significantly improved from 70% in Group A to 92% in Group B.
• These improvements indicate a clear learning curve effect within the study period.

Conclusions:

• The learning curve for pancreatoduodenectomy demonstrates a significant improvement in surgical outcomes with increasing experience.
• While overall trends show improvement, individual surgeon learning curves can differ, influencing patient outcomes.
• These findings highlight the importance of experience and continuous learning in mastering complex oncologic surgeries.