TY - JOUR
T1 - A nationwide certification system to increase the safety of highly advanced hepatobiliary-pancreatic surgery
AU - Otsubo, Takehito
AU - Kobayashi, Shinjiro
AU - Sano, Keiji
AU - Misawa, Takeyuki
AU - Katagiri, Satoshi
AU - Nakayama, Hisashi
AU - Suzuki, Shuji
AU - Watanabe, Manabu
AU - Ariizumi, Shunichi
AU - Unno, Michiaki
AU - Tanabe, Minoru
AU - Nagano, Hiroaki
AU - Kokudo, Norihiro
AU - Hirano, Satoshi
AU - Nakamura, Masafumi
AU - Shirabe, Ken
AU - Suzuki, Yasuyuki
AU - Yoshida, Masahiro
AU - Takada, Yasutsugu
AU - Nakagohri, Toshio
AU - Horiguchi, Akihiko
AU - Ohdan, Hideki
AU - Eguchi, Susumu
AU - Ohtsuka, Masayuki
AU - Sho, Masayuki
AU - Rikiyama, Toshiki
AU - Hatano, Etsuro
AU - Taketomi, Akinobu
AU - Fujii, Tsutomu
AU - Yamaue, Hiroki
AU - Miyazaki, Masaru
AU - Yamamoto, Masakazu
AU - Takada, Tadahiro
AU - Endo, Itaru
N1 - Funding Information:
We wish to express our sincere gratitude to all of the board-certified training institutions of the JSHBPS. We also thank Prof. Tina Tajima, Research Institute of Medical Education, St. Marianna University School of Medicine, for her guidance in English and to Prof. Eisuke Inoue, Center for the Promotion of Integrated Research, Showa University, for his guidance in statistics in the preparation of this paper.
Publisher Copyright:
© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
PY - 2023/1
Y1 - 2023/1
N2 - Background: To ensure that highly advanced hepatobiliary-pancreatic surgery (HBPS) is performed safely, the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons established a safety committee to monitor surgical safety. Methods: We investigated postoperative mortality rates based on summary reports of numbers and outcomes of highly advanced HBPS submitted annually by the board-certified training institutions from 2012 to 2019. We also analyzed summary reports on mortality cases submitted by institutions with high 90-day post-HBPS mortality rates and recommended site visits and surveys as necessary. Results: Highly advanced HBPS was performed in 121 518 patients during the 8-year period. Thirty-day mortality rates from 2012 to 2019 were 0.92%, 0.8%, 0.61%, 0.63%, 0.70%, 0.59%, 0.48%, and 0.52%, respectively (P <.001). Ninety-day mortality rates were 2.1%, 1.82%, 1.62%, 1.28%, 1.46%, 1.22%, 1.19%, and 0.98%, respectively (P <.001). Summary reports were submitted by 20 hospitals between 2015 and 2019. Mortality rates before and after the start of report submission and audit were 5.72% and 2.79%, respectively (odds ratio 0.690, 95% confidence interval 0.487-0.977; P =.037). Conclusions: Development of a system for designation of board-certified expert surgeons and safety management improved the mortality rate associated with highly advanced HBPS.
AB - Background: To ensure that highly advanced hepatobiliary-pancreatic surgery (HBPS) is performed safely, the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) board certification system for expert surgeons established a safety committee to monitor surgical safety. Methods: We investigated postoperative mortality rates based on summary reports of numbers and outcomes of highly advanced HBPS submitted annually by the board-certified training institutions from 2012 to 2019. We also analyzed summary reports on mortality cases submitted by institutions with high 90-day post-HBPS mortality rates and recommended site visits and surveys as necessary. Results: Highly advanced HBPS was performed in 121 518 patients during the 8-year period. Thirty-day mortality rates from 2012 to 2019 were 0.92%, 0.8%, 0.61%, 0.63%, 0.70%, 0.59%, 0.48%, and 0.52%, respectively (P <.001). Ninety-day mortality rates were 2.1%, 1.82%, 1.62%, 1.28%, 1.46%, 1.22%, 1.19%, and 0.98%, respectively (P <.001). Summary reports were submitted by 20 hospitals between 2015 and 2019. Mortality rates before and after the start of report submission and audit were 5.72% and 2.79%, respectively (odds ratio 0.690, 95% confidence interval 0.487-0.977; P =.037). Conclusions: Development of a system for designation of board-certified expert surgeons and safety management improved the mortality rate associated with highly advanced HBPS.
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U2 - 10.1002/jhbp.1186
DO - 10.1002/jhbp.1186
M3 - Article
C2 - 35611453
AN - SCOPUS:85131714461
SN - 1868-6974
VL - 30
SP - 60
EP - 71
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 1
ER -