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Learning curve for pancreatoduodenectomy: can it be generalized?
Hyeong Min Park1, Sung-Sik Han1, Sang-Jae Park1
1Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang-si, South Korea.
ANZ Journal of Surgery
|April 8, 2020
Summary
A learning curve exists for pancreatoduodenectomy (PD), but the specific factors and improvement rates vary between surgeons. This study analyzed PD outcomes for 300 patients across two surgeons to identify these differences.
Area of Science:
- Surgical outcomes research
- Learning curve analysis in surgery
Background:
- The existence of a learning curve in pancreatoduodenectomy (PD) is hypothesized.
- Surgeon-specific factors influencing the learning curve and improvement rates require investigation.
Purpose of the Study:
- To investigate the presence and nature of a learning curve in pancreatoduodenectomy (PD).
- To compare the learning curve factors and improvement trajectories between two individual surgeons performing PD.
Main Methods:
- Analysis of 300 pancreatoduodenectomy (PD) outcomes from 2001-2014.
- Patients were divided into three chronological groups (50 cases each) per surgeon.
- Outcomes including operation time and blood transfusion were assessed for learning curve effects.
Main Results:
- Surgeon A showed progressive decreases in operation time and red blood cell transfusion needs.
- Surgeon B demonstrated a decrease in operation time that plateaued around 100 cases.
- No significant improvements were observed in post-operative complications, re-operation rates, mortality, or length of stay for either surgeon.
Conclusions:
- A learning curve for pancreatoduodenectomy (PD) is evident.
- The specific factors demonstrating a learning curve and the rate of improvement differ significantly between surgeons.
