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Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study.

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Defining benchmarks for gallbladder cancer (GBC) surgery is crucial for improving oncologic care. This study established international benchmarks for GBC surgical outcomes, including complication rates and hospital stay duration.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • High-quality surgery is essential for optimal oncologic care.
  • Establishing benchmark values allows for the assessment of achievable surgical results.
  • Gallbladder cancer (GBC) surgery requires defined quality standards.

Purpose of the Study:

  • To define international benchmark values for gallbladder cancer (GBC) surgery.
  • To establish standards for assessing GBC surgical quality and outcomes.

Main Methods:

  • Retrospective analysis of 906 patients undergoing curative-intent GBC surgery (2000-2021) at 13 international centers.
  • Benchmark group comprised patients from high-volume centers without vascular/bile duct reconstruction or significant comorbidities.
  • Data collected on patient demographics, operative details, and postoperative outcomes.

Main Results:

  • 245 patients (27%) formed the benchmark group, predominantly women (71%), median age 64.
  • Benchmark complication rates: ≤22% overall, ≤11% for major (Clavien-Dindo grade ≥ IIIa) complications.
  • Key benchmarks established: ≥4 lymph nodes retrieved, blood loss ≤350 mL, hospital stay ≤8 days, R1 margin ≤7%.

Conclusions:

  • Gallbladder cancer surgery is associated with considerable morbidity.
  • Defined benchmark values provide a framework for comparing GBC surgical approaches and centers.
  • These benchmarks can guide quality improvement initiatives in GBC surgical care.