Learning curve for pancreatoduodenectomy: can it be generalized?
Background We hypothesized that a learning curve exists for pancreatoduodenectomy (PD) and that the factors that show a learning curve and the degree of improvement over time differ among surgeons. Methods We analysed the outcomes of PD in 300 patients operated by two surgeons between 2001 and 2014;...
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| Veröffentlicht in: | ANZ journal of surgery 2020-07, Vol.90 (7-8), p.1414-1421 |
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| container_title | ANZ journal of surgery |
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| creator | Park, Hyeong Min Han, Sung‐Sik Park, Sang‐Jae Kim, Sun‐Whe |
| description | Background
We hypothesized that a learning curve exists for pancreatoduodenectomy (PD) and that the factors that show a learning curve and the degree of improvement over time differ among surgeons.
Methods
We analysed the outcomes of PD in 300 patients operated by two surgeons between 2001 and 2014; these comprised the first 150 patients operated by each surgeon. Patients operated by each surgeon were classified into three groups according to the chronological sequence of operation (50 patients per group).
Results
For surgeon A, the median operation time (496 versus 454 versus 418 min, P |
| doi_str_mv | 10.1111/ans.15874 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1111_ans_15874</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2436314749</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3534-95bf2f3f2428a313be38700f016d890b27dfcf474b29a4f6701da2422376124a3</originalsourceid><addsrcrecordid>eNqNkElLBDEQhYMo7gf_gDR4UWScrL14URncYNCDeg7pdEUiPcmYdCvjrzc64xwEwbpUUXz16vEQ2iP4hKQaKhdPiCgLvoI2CediQElVrC5mwhnbQFsxvmBM8rwS62iDUSoEzcUmOh-DCs6650z34Q0y40M2VU4HUJ1vet-AA935yew008pltstqyJ7TMqjWfkBztoPWjGoj7C76Nnq6unwc3QzG99e3o4vxQDPB-KAStaGGGcppqRhhNbCywNgkS01Z4ZoWjdGGF7ymleImLzBpVIIpK3JCuWLb6HCuOw3-tYfYyYmNGtpWOfB9lDTpUcFFxRJ68At98X1wyZ2knOWMpDdVoo7mlA4-xgBGToOdqDCTBMuvWGWKVX7Hmtj9hWJfT6BZkj85JuB4DrxD7U3UFpyGJYYxFukzYSxNmCS6_D89sp3qrHcj37sunQ4Xp7aF2d-W5cXdw9z7JylHn3Y</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2436314749</pqid></control><display><type>article</type><title>Learning curve for pancreatoduodenectomy: can it be generalized?</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Park, Hyeong Min ; Han, Sung‐Sik ; Park, Sang‐Jae ; Kim, Sun‐Whe</creator><creatorcontrib>Park, Hyeong Min ; Han, Sung‐Sik ; Park, Sang‐Jae ; Kim, Sun‐Whe</creatorcontrib><description>Background
We hypothesized that a learning curve exists for pancreatoduodenectomy (PD) and that the factors that show a learning curve and the degree of improvement over time differ among surgeons.
Methods
We analysed the outcomes of PD in 300 patients operated by two surgeons between 2001 and 2014; these comprised the first 150 patients operated by each surgeon. Patients operated by each surgeon were classified into three groups according to the chronological sequence of operation (50 patients per group).
Results
For surgeon A, the median operation time (496 versus 454 versus 418 min, P < 0.001) and the mean amount of red blood cell transfusion (3.76 versus 2.76 versus 1.26 packs, P < 0.001) showed a slight but progressive decrease from the first 50 cases to the second and the third 50 cases. For surgeon B, only the operation time, which decreased and ultimately plateaued at approximately case 100, was significantly different among the groups. There was no improvement in post‐operative complications, re‐operation rates, mortality, length of stay and re‐admission rates over time for both surgeons.
Conclusion
We demonstrated that a learning curve for PD exists with respect to various factors. However, the factors for which learning curves were exhibited and the degree of improvement over time were different between the two surgeons.
This study demonstrates a learning curve for pancreatoduodenectomy with respect to various factors. However, there was considerable inter‐individual variability with respect to the aspects that showed a learning curve and the degree of improvement over time.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.15874</identifier><identifier>PMID: 32255265</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Blood transfusion ; Clinical Competence ; Complications ; Erythrocytes ; high‐volume hospital ; Humans ; Learning ; Learning Curve ; Learning curves ; Length of Stay ; Life Sciences & Biomedicine ; Operative Time ; Pancreaticoduodenectomy ; pancreatoduodenectomy ; Postoperative Complications - epidemiology ; Retrospective Studies ; Science & Technology ; Surgeons ; Surgery ; Transfusion</subject><ispartof>ANZ journal of surgery, 2020-07, Vol.90 (7-8), p.1414-1421</ispartof><rights>2020 Royal Australasian College of Surgeons</rights><rights>2020 Royal Australasian College of Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>4</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000524313300001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3534-95bf2f3f2428a313be38700f016d890b27dfcf474b29a4f6701da2422376124a3</citedby><cites>FETCH-LOGICAL-c3534-95bf2f3f2428a313be38700f016d890b27dfcf474b29a4f6701da2422376124a3</cites><orcidid>0000-0002-7579-0241</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.15874$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.15874$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27928,27929,28252,45578,45579</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32255265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Hyeong Min</creatorcontrib><creatorcontrib>Han, Sung‐Sik</creatorcontrib><creatorcontrib>Park, Sang‐Jae</creatorcontrib><creatorcontrib>Kim, Sun‐Whe</creatorcontrib><title>Learning curve for pancreatoduodenectomy: can it be generalized?</title><title>ANZ journal of surgery</title><addtitle>ANZ J SURG</addtitle><addtitle>ANZ J Surg</addtitle><description>Background
We hypothesized that a learning curve exists for pancreatoduodenectomy (PD) and that the factors that show a learning curve and the degree of improvement over time differ among surgeons.
Methods
We analysed the outcomes of PD in 300 patients operated by two surgeons between 2001 and 2014; these comprised the first 150 patients operated by each surgeon. Patients operated by each surgeon were classified into three groups according to the chronological sequence of operation (50 patients per group).
Results
For surgeon A, the median operation time (496 versus 454 versus 418 min, P < 0.001) and the mean amount of red blood cell transfusion (3.76 versus 2.76 versus 1.26 packs, P < 0.001) showed a slight but progressive decrease from the first 50 cases to the second and the third 50 cases. For surgeon B, only the operation time, which decreased and ultimately plateaued at approximately case 100, was significantly different among the groups. There was no improvement in post‐operative complications, re‐operation rates, mortality, length of stay and re‐admission rates over time for both surgeons.
Conclusion
We demonstrated that a learning curve for PD exists with respect to various factors. However, the factors for which learning curves were exhibited and the degree of improvement over time were different between the two surgeons.
This study demonstrates a learning curve for pancreatoduodenectomy with respect to various factors. However, there was considerable inter‐individual variability with respect to the aspects that showed a learning curve and the degree of improvement over time.</description><subject>Blood transfusion</subject><subject>Clinical Competence</subject><subject>Complications</subject><subject>Erythrocytes</subject><subject>high‐volume hospital</subject><subject>Humans</subject><subject>Learning</subject><subject>Learning Curve</subject><subject>Learning curves</subject><subject>Length of Stay</subject><subject>Life Sciences & Biomedicine</subject><subject>Operative Time</subject><subject>Pancreaticoduodenectomy</subject><subject>pancreatoduodenectomy</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Transfusion</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkElLBDEQhYMo7gf_gDR4UWScrL14URncYNCDeg7pdEUiPcmYdCvjrzc64xwEwbpUUXz16vEQ2iP4hKQaKhdPiCgLvoI2CediQElVrC5mwhnbQFsxvmBM8rwS62iDUSoEzcUmOh-DCs6650z34Q0y40M2VU4HUJ1vet-AA935yew008pltstqyJ7TMqjWfkBztoPWjGoj7C76Nnq6unwc3QzG99e3o4vxQDPB-KAStaGGGcppqRhhNbCywNgkS01Z4ZoWjdGGF7ymleImLzBpVIIpK3JCuWLb6HCuOw3-tYfYyYmNGtpWOfB9lDTpUcFFxRJ68At98X1wyZ2knOWMpDdVoo7mlA4-xgBGToOdqDCTBMuvWGWKVX7Hmtj9hWJfT6BZkj85JuB4DrxD7U3UFpyGJYYxFukzYSxNmCS6_D89sp3qrHcj37sunQ4Xp7aF2d-W5cXdw9z7JylHn3Y</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Park, Hyeong Min</creator><creator>Han, Sung‐Sik</creator><creator>Park, Sang‐Jae</creator><creator>Kim, Sun‐Whe</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley</general><general>Blackwell Publishing Ltd</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7579-0241</orcidid></search><sort><creationdate>202007</creationdate><title>Learning curve for pancreatoduodenectomy: can it be generalized?</title><author>Park, Hyeong Min ; Han, Sung‐Sik ; Park, Sang‐Jae ; Kim, Sun‐Whe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-95bf2f3f2428a313be38700f016d890b27dfcf474b29a4f6701da2422376124a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Blood transfusion</topic><topic>Clinical Competence</topic><topic>Complications</topic><topic>Erythrocytes</topic><topic>high‐volume hospital</topic><topic>Humans</topic><topic>Learning</topic><topic>Learning Curve</topic><topic>Learning curves</topic><topic>Length of Stay</topic><topic>Life Sciences & Biomedicine</topic><topic>Operative Time</topic><topic>Pancreaticoduodenectomy</topic><topic>pancreatoduodenectomy</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Transfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Hyeong Min</creatorcontrib><creatorcontrib>Han, Sung‐Sik</creatorcontrib><creatorcontrib>Park, Sang‐Jae</creatorcontrib><creatorcontrib>Kim, Sun‐Whe</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Hyeong Min</au><au>Han, Sung‐Sik</au><au>Park, Sang‐Jae</au><au>Kim, Sun‐Whe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Learning curve for pancreatoduodenectomy: can it be generalized?</atitle><jtitle>ANZ journal of surgery</jtitle><stitle>ANZ J SURG</stitle><addtitle>ANZ J Surg</addtitle><date>2020-07</date><risdate>2020</risdate><volume>90</volume><issue>7-8</issue><spage>1414</spage><epage>1421</epage><pages>1414-1421</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
We hypothesized that a learning curve exists for pancreatoduodenectomy (PD) and that the factors that show a learning curve and the degree of improvement over time differ among surgeons.
Methods
We analysed the outcomes of PD in 300 patients operated by two surgeons between 2001 and 2014; these comprised the first 150 patients operated by each surgeon. Patients operated by each surgeon were classified into three groups according to the chronological sequence of operation (50 patients per group).
Results
For surgeon A, the median operation time (496 versus 454 versus 418 min, P < 0.001) and the mean amount of red blood cell transfusion (3.76 versus 2.76 versus 1.26 packs, P < 0.001) showed a slight but progressive decrease from the first 50 cases to the second and the third 50 cases. For surgeon B, only the operation time, which decreased and ultimately plateaued at approximately case 100, was significantly different among the groups. There was no improvement in post‐operative complications, re‐operation rates, mortality, length of stay and re‐admission rates over time for both surgeons.
Conclusion
We demonstrated that a learning curve for PD exists with respect to various factors. However, the factors for which learning curves were exhibited and the degree of improvement over time were different between the two surgeons.
This study demonstrates a learning curve for pancreatoduodenectomy with respect to various factors. However, there was considerable inter‐individual variability with respect to the aspects that showed a learning curve and the degree of improvement over time.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32255265</pmid><doi>10.1111/ans.15874</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7579-0241</orcidid></addata></record> |
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| subjects | Blood transfusion Clinical Competence Complications Erythrocytes high‐volume hospital Humans Learning Learning Curve Learning curves Length of Stay Life Sciences & Biomedicine Operative Time Pancreaticoduodenectomy pancreatoduodenectomy Postoperative Complications - epidemiology Retrospective Studies Science & Technology Surgeons Surgery Transfusion |
| title | Learning curve for pancreatoduodenectomy: can it be generalized? |
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