A nationwide certification system to increase the safety of highly advanced hepatobiliary‐pancreatic surgery. (13th June 2022)

• Record Type: Journal Article
• Authors: Otsubo, Takehito; Kobayashi, Shinjiro; Sano, Keiji; Misawa, Takeyuki; Katagiri, Satoshi; Nakayama, Hisashi; Suzuki, Shuji; Watanabe, Manabu; Ariizumi, Shunichi; Unno, Michiaki; Tanabe, Minoru; Nagano, Hiroaki; Kokudo, Norihiro; Hirano, Satoshi; Nakamura, Masafumi; Shirabe, Ken; Suzuki, Yasuyuki; Yoshida, Masahiro; Takada, Yasutsugu; Nakagohri, Toshio; Horiguchi, Akihiko; Ohdan, Hideki; Eguchi, Susumu; Ohtsuka, Masayuki; Sho, Masayuki; Rikiyama, Toshiki; Hatano, Etsuro; Taketomi, Akinobu; Fujii, Tsutomu; Yamaue, Hiroki; Miyazaki, Masaru; Yamamoto, Masakazu; Takada, Tadahiro; Endo, Itaru;
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 30:Number 1(2023)
• Page Start: 60
• Page End: 71
• Publication Date: 2022-06-13
• Subjects: board certification system for expert surgeons -- hepatobiliary‐pancreatic surgery -- mortality -- surgical outcomes; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.1186
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: 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. Abstract : Ohtsubo and colleagues report that the 90‐day mortality rate decreased from 2.10% to 0.98% through implementation by the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery of a board certification system for expert surgeons along with certification of training institutions that produce surgeons capable of safely performing highly advanced hepatobiliary‐pancreatic surgery.