Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Not refereed |
Title | Validation of the board certification system for expert surgeons (hepato-biliary-pancreatic field) using the data of the National Clinical Database of Japan: part 2 - Pancreatoduodenectomy |
Journal | Formal name:Journal of hepato-biliary-pancreatic sciences Abbreviation:J Hepatobiliary Pancreat Sci ISSN code:1868-6982(Electronic)1868-6974(Linking) |
Domestic / Foregin | Foregin |
Volume, Number, Page | 23(6),pp.353-63 |
Papers・Author | Miura Fumihiko, Yamamoto Masakazu, Gotoh Mitsukazu, Konno Hiroyuki, Fujimoto Jiro, Yanaga Katsuhiko, Kokudo Norihiro, Yamaue Hiroki, Wakabayashi Go, Seto Yasuyuki, Unno Michiaki, Miyata Hiroaki, Hirahara Norimichi, Miyazaki Masaru |
Publication date | 2016/06 |
Papers・Description | BACKGROUND:Data of pancreatoduodenectomy (PD) cases from the National Clinical Database (NCD) were analyzed in order to validate the board certification system established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS).METHODS:Board-certified A training institutions and board-certified B training institutions were required to perform at least 50 and 30 high-level hepato-biliary-pancreatic (HBP) surgeries per year, respeMETHODS:ctively. Records of 17,563 patients who had undergone PD during 2011 and 2012 were retrospectively analyzed according to the category of the board-certified institution and with or without participation of board-certified instructors or expert surgeons.RESULTS:Operative mortality rates after PDs performed at certified A institutions, certified B institutions, and non-certified institutions were 1.5%, 3.0%, and 3.9%, respectively (PRESULTS:<RESULTS:0.001). The operative mortality rates after PDs performed with participation of certified instructors or expert surgeons were better than those without (2.2% vs. 3.8%, PRESULTS:<RESULTS:0.001). A multiple logistic regression model showed that cutoffs of high-level HBP surgeries performed per year at hospitals that predicted 30-day mortality after PDs were 10 and 50, and that those that predicted operative mortality were 10 and 70.CONCLUSIONS:The requirements for board-certified institutions, instructors, and expert surgeons to perform PD were appropriate. The requirements for board-certified A institutions were close to the identified cutoffs. Further analyses are necessary to elucidate the implications of the board certification system. |
DOI | 10.1002/jhbp.348 |
PMID | 26994315 |