ARIIZUMI Shunichi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title A nationwide certification system to increase the safety of highly advanced hepatobiliary-pancreatic surgery.
Journal Formal name:Journal of hepato-biliary-pancreatic sciences
Abbreviation:J Hepatobiliary Pancreat Sci
ISSN code:18686982/18686974
Domestic / ForeginDomestic
Volume, Issue, Page 30(1),pp.60-71
Author and coauthor 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, YOSHIA 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
Publication date 2023/01
Summary 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.
DOI 10.1002/jhbp.1186
PMID 35611453