Increased Surgical Risks in Hepatobiliary and Pancreatic Surgery Following the Shift to Single-Surgeon Practice...

Area of Science:

• Surgical Outcomes
• Healthcare Policy Impact
• Medical Practice Evolution

Background:

• Assistive surgical personnel are vital for patient outcomes and efficiency.
• A nationwide trainee strike in South Korea (March 2024) led to widespread solo-surgeon procedures.
• This study investigates the impact of this practice shift on surgical results.

Purpose of the Study:

• To evaluate the effect of solo-surgeon procedures versus surgeries with assistant doctors on patient outcomes.
• To identify prognostic factors influencing surgical results during a period of reduced surgical assistance.

Main Methods:

• Prospectively collected surgical records from CHA Bundang Medical Center were analyzed.
• Patients undergoing hepatobiliary and pancreatic surgery were divided into pre-strike (assistant) and post-strike (solo-surgeon) groups.
• Propensity score matching was used to compare outcomes between 388 matched pairs.

Main Results:

• Overall complication rates were similar, but major complications were significantly higher in the solo-surgeon group (4.6% vs. 1.8%).
• Operative time and hospital length of stay did not differ significantly between the groups.
• A trend towards increased major complications was observed in open surgeries and elderly patients performed by solo surgeons.

Conclusions:

• Transitioning to solo-surgeon practice in hepatobiliary and pancreatic surgery may increase major complication rates, especially in complex cases.
• A team-based surgical approach might enhance outcomes for specific patient groups.
• Further research is warranted to confirm these findings and inform surgical staffing practices.