Quality performance indicators for hepato-pancreatico-biliary procedures: a systematic review

Area of Science:

• Surgical Quality Improvement
• Health Services Research
• Gastroenterology & Hepatology

Background:

• Hepato-pancreatico-biliary (HPB) surgery involves complex procedures with significant patient impact.
• Standardized quality performance indicators (QPI) are crucial for assessing and improving surgical care.
• Existing QPI for HPB procedures are diverse and lack international consensus.

Purpose of the Study:

• To define and summarize existing and proposed quality performance indicators (QPI) for hepato-pancreatico-biliary (HPB) surgical procedures.
• To identify the methodologies used in developing these QPI.
• To highlight the current gaps in internationally agreed-upon QPI for HPB surgery.

Main Methods:

• Systematic literature review of MEDLINE, EMBASE, PubMed, and SCOPUS databases up to May 1, 2020.
• Manual searching of reference lists and related review articles to identify additional relevant studies.
• Inclusion of studies reporting QPI for cholecystectomy, hepatectomy, pancreatectomy, and complex biliary procedures.

Main Results:

• Forty-five publications reported QPI for pancreatectomy (22), hepatectomy (7), general HPB resections (12), and cholecystectomy (6).
• No QPI were identified for complex biliary surgery.
• Sixty-one QPI for pancreatectomy, 22 for hepatectomy, and 14 for general HPB resections were reported across infrastructure, provider, and documentation domains.

Conclusions:

• A significant number of QPI have been proposed for various HPB procedures, but consensus is lacking.
• There is a notable absence of internationally agreed-upon QPI for HPB procedures.
• Developing globally accepted QPI is essential for comparing provider performance and advancing patient care standards in HPB surgery.