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Practice patterns of hepatobiliary surgery within the military
Camille R Suydam1, Marcos C Aranda2, Thomas A O'Hara2
1Department of Surgery, Eisenhower Army Medical Center, Fort Gordon, USA. camille.r.suydam.mil@health.mil.
Surgical Endoscopy
|July 6, 2023
Summary
Hepatobiliary surgeries in military hospitals remained stable from 2014-2020, contrary to national centralization trends. This stability may affect future surgical resident training and military medical readiness.
Area of Science:
- Surgical Oncology
- Military Medicine
- Health Services Research
Background:
- National trends suggest centralization of surgical services improves patient outcomes.
- The U.S. military lacks a specific policy for centralizing surgical specialties.
- Complex procedures like hepatobiliary surgeries may see de facto centralization.
Purpose of the Study:
- To analyze trends in hepatobiliary surgeries within military hospitals.
- To assess the potential impact of these trends on surgical residency training.
- To evaluate implications for military medical readiness.
Main Methods:
- Retrospective review of de-identified data from the Military Health System Mart (M2) database (2014-2020).
- Included data from all Defense Health Agency treatment facilities across U.S. military branches.
- Utilized linear regression to identify trends in surgical case volumes over time.
Main Results:
- A total of 1,087 hepatobiliary surgeries were performed across 55 military hospitals (2014-2020), excluding common procedures like cholecystectomies.
- No significant decrease in overall hepatobiliary surgery case volume was observed.
- The most frequent procedure was 'unlisted laparoscopic liver procedure'; Brooke Army Medical Center performed the most cases.
Conclusions:
- Hepatobiliary surgery volumes in military hospitals did not significantly decline between 2014 and 2020.
- Observed trends contrast with national patterns favoring centralization of complex surgeries.
- Future centralization could influence surgical residency programs and military medical readiness.
