A nationwide certification system to increase the safety of highly advanced hepatobiliary‐pancreatic surgery

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