Centralisatie pancreaschirurgie reduceert postoperatieve sterfte in Nederland*

Objective

To analyse the extent of centralisation of pancreaticoduodenectomy (Whipple procedure) and changes in in-hospital mortality rates in the Netherlands.

Design

Retrospective analysis.

Methods

Data on patients who had undergone pancreaticoduodenectomy (PD) during the 2004-2009 period was acquired from the Kiwa Prismant registry. Based on the number of procedures performed annually, hospitals were divided into 4 volume-categories: very-low (

Results

2155 patients who had undergone PD were included. The number of hospitals performing PD decreased from 48 in 2004 to 30 in 2009 (p = 0.01). The proportion of patients who had undergone PD in a medium- or high-volume hospital increased from 52.9% to 91.2% (p

Conclusion

Nationwide centralisation of PD is occurring in Netherlands, and this is associated with a decrease in in-hospital mortality. Further centralisation is likely to further decrease in-hospital mortality, especially in the elderly.

Conflict of interest: none declared. Financial support: none declared.