Teaching modern pancreatic surgery: close relationship between centralization, innovation, and dissemination of care.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
05 09 2023
05 09 2023
Historique:
received:
10
07
2023
accepted:
19
07
2023
medline:
14
9
2023
pubmed:
12
9
2023
entrez:
12
9
2023
Statut:
ppublish
Résumé
Pancreatic surgery is increasingly moving towards centralization in high-volume centres, supported by evidence on the volume-outcome relationship. At the same time, minimally invasive pancreatic surgery is becoming more and more established worldwide, and interest in new techniques, such as robotic pancreatoduodenectomy, is growing. Such recent innovations are reshaping modern pancreatic surgery, but they also represent new challenges for surgical training in its current form. This narrative review presents a chosen selection of literature, giving a picture of the current state of training in pancreatic surgery, together with the authors' own views, and in the context of centralization and innovation towards minimally invasive techniques. Centralization of pancreatic surgery at high-volume centres, volume-outcome relationships, innovation through minimally invasive technologies, learning curves in both traditional and minimally invasive surgery, and standardized training paths are the different, but deeply interconnected, topics of this article. Proper training is essential to ensure quality of care, but innovation and centralization may represent challenges to overcome with new training models. Innovations in pancreatic surgery are introduced with the aim of increasing the quality of care. However, their successful implementation is deeply dependent on dissemination and standardization of surgical training, adapted to fit in the changing landscape of modern pancreatic surgery.
Sections du résumé
BACKGROUND
Pancreatic surgery is increasingly moving towards centralization in high-volume centres, supported by evidence on the volume-outcome relationship. At the same time, minimally invasive pancreatic surgery is becoming more and more established worldwide, and interest in new techniques, such as robotic pancreatoduodenectomy, is growing. Such recent innovations are reshaping modern pancreatic surgery, but they also represent new challenges for surgical training in its current form.
METHODS
This narrative review presents a chosen selection of literature, giving a picture of the current state of training in pancreatic surgery, together with the authors' own views, and in the context of centralization and innovation towards minimally invasive techniques.
RESULTS
Centralization of pancreatic surgery at high-volume centres, volume-outcome relationships, innovation through minimally invasive technologies, learning curves in both traditional and minimally invasive surgery, and standardized training paths are the different, but deeply interconnected, topics of this article. Proper training is essential to ensure quality of care, but innovation and centralization may represent challenges to overcome with new training models.
CONCLUSION
Innovations in pancreatic surgery are introduced with the aim of increasing the quality of care. However, their successful implementation is deeply dependent on dissemination and standardization of surgical training, adapted to fit in the changing landscape of modern pancreatic surgery.
Identifiants
pubmed: 37698977
pii: 7271146
doi: 10.1093/bjsopen/zrad081
pmc: PMC10496870
pii:
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
Références
Ann Surg. 2022 Jul 1;276(1):159-166
pubmed: 33234781
Surgery. 2007 May;141(5):694-701
pubmed: 17511115
Surg Endosc. 2016 May;30(5):1778-83
pubmed: 26275542
J Gastrointest Surg. 2019 Oct;23(10):2081-2092
pubmed: 31037503
J Gastrointest Surg. 2019 Nov;23(11):2324-2325
pubmed: 31512102
JAMA Surg. 2020 Jul 1;155(7):607-615
pubmed: 32432666
Ann Surg. 2020 Feb;271(2):356-363
pubmed: 29864089
Ann Surg. 2018 Nov;268(5):731-739
pubmed: 30138162
HPB (Oxford). 2017 Mar;19(3):171-177
pubmed: 28189345
HPB (Oxford). 2019 Jan;21(1):34-42
pubmed: 30097413
Br J Surg. 2007 Nov;94(11):1377-81
pubmed: 17657717
Eur J Surg Oncol. 2016 Feb;42(2):190-6
pubmed: 26705143
Langenbecks Arch Surg. 2022 Dec;407(8):3423-3435
pubmed: 36114350
Ann Surg. 2019 Jan;269(1):2-9
pubmed: 30080726
Ann Surg. 2016 Aug;264(2):257-67
pubmed: 26863398
HPB (Oxford). 2018 Aug;20(8):759-767
pubmed: 29571615
Surgery. 2022 Jul;172(1):319-328
pubmed: 35221107
Ann Surg. 2021 Jul 1;274(1):e18-e27
pubmed: 30946088
Ann Surg. 2015 Aug;262(2):372-7
pubmed: 26158612
Surg Endosc. 2022 Jun;36(6):4518-4528
pubmed: 34799744
J Am Coll Surg. 2021 Sep;233(3):395-414
pubmed: 34166838
Ann Surg. 2005 Dec;242(6):781-8, discussion 788-90
pubmed: 16327488
World J Surg. 2018 Apr;42(4):1138-1146
pubmed: 29018911
J Am Coll Surg. 2010 Sep;211(3):325-30
pubmed: 20800188
HPB (Oxford). 2016 Apr;18(4):317-24
pubmed: 27037200
N Engl J Med. 2015 Oct 8;373(15):1388-90
pubmed: 26444728
Surgery. 2016 Nov;160(5):1392-1399
pubmed: 27302101
Br J Surg. 2014 Apr;101(5):523-9
pubmed: 24615349
J Am Coll Surg. 2015 May;220(5):831-8
pubmed: 25840531
Br J Surg. 2012 Mar;99(3):404-10
pubmed: 22237731
Ann Surg. 2023 Jun 8;:
pubmed: 37288547
N Engl J Med. 2011 Jun 2;364(22):2128-37
pubmed: 21631325
Surgery. 2021 Jun;169(6):1456-1462
pubmed: 33386130
J Hepatobiliary Pancreat Sci. 2018 Nov;25(11):498-507
pubmed: 30291768
JAMA. 1995 Jul 26;274(4):317-23
pubmed: 7609261
Surgery. 2015 Apr;157(4):752-63
pubmed: 25794627
Ann Surg Open. 2022 Jan 27;3(1):e111
pubmed: 37600094
J Am Coll Surg. 2017 May;224(5):826-832.e1
pubmed: 28126547
Ann Surg. 2017 Nov;266(5):797-804
pubmed: 28885506
JAMA Surg. 2017 Apr 1;152(4):336-342
pubmed: 28030713
HPB (Oxford). 2017 Mar;19(3):234-245
pubmed: 28190709
N Engl J Med. 2013 Oct 10;369(15):1434-42
pubmed: 24106936
J Am Coll Surg. 2022 Sep 1;235(3):383-390
pubmed: 35972156
Ann Surg. 2016 Apr;263(4):692-7
pubmed: 26501706
Ann Surg. 2022 Dec 1;276(6):1029-1038
pubmed: 33630454
HPB (Oxford). 2019 Mar;21(3):319-327
pubmed: 30297306
Ann Surg. 2018 Jul;268(1):151-157
pubmed: 28486387
J Surg Oncol. 2020 Jul;122(1):41-48
pubmed: 32215926
Ann Surg. 2013 Sep;258(3):440-9
pubmed: 24022436
Lancet Gastroenterol Hepatol. 2021 Jun;6(6):438-447
pubmed: 33915091
Ann Surg. 2021 May 1;273(5):966-972
pubmed: 31851003
Med Care. 2011 Dec;49(12):1076-81
pubmed: 22002649
J Gastrointest Surg. 2016 May;20(5):924-35
pubmed: 26902090
Surg Endosc. 1994 May;8(5):408-10
pubmed: 7915434
HPB (Oxford). 2020 May;22(5):637-648
pubmed: 31836284
Ann Surg. 2018 Mar;267(3):411-417
pubmed: 28379871
Ann Surg. 2019 Aug;270(2):211-218
pubmed: 30829701
Med Care. 2017 Jun;55(6):606-614
pubmed: 28288072
J Am Coll Surg. 2015 Jul;221(1):175-84
pubmed: 26095569
Am J Transplant. 2016 Apr;16(4):1086-93
pubmed: 26928942
J Surg Educ. 2017 May - Jun;74(3):477-485
pubmed: 27884677
Lancet Gastroenterol Hepatol. 2019 Mar;4(3):199-207
pubmed: 30685489
Surg Today. 2013 Mar;43(3):271-5
pubmed: 22941345
Ann Surg. 2022 Dec 1;276(6):e886-e895
pubmed: 33534227
Ann Surg. 2019 Dec;270(6):1147-1155
pubmed: 29771723
N Engl J Med. 2003 Nov 27;349(22):2117-27
pubmed: 14645640
J Am Coll Surg. 2017 Aug;225(2):226-234.e2
pubmed: 28414116
Ann Surg Oncol. 2018 Nov;25(12):3445-3452
pubmed: 30073601
J Gastrointest Surg. 2012 Aug;16(8):1597-604
pubmed: 22714746
J Am Coll Surg. 2015 Mar;220(3):263-270.e1
pubmed: 25600974
Br J Surg. 2014 Jul;101(8):1000-5
pubmed: 24844590
HPB (Oxford). 2017 Oct;19(10):919-926
pubmed: 28754367
HPB (Oxford). 2017 Mar;19(3):190-204
pubmed: 28215904
Ann Surg. 2016 Sep;264(3):482-91
pubmed: 27433897
Ann Surg. 2021 Dec 1;274(6):e1277-e1283
pubmed: 31651533
J Surg Educ. 2022 Jul-Aug;79(4):861-866
pubmed: 35351431
BJS Open. 2020 Oct;4(5):904-913
pubmed: 32893988
Health Mark Q. 2020 Jan-Mar;37(1):41-57
pubmed: 31928336
Br J Surg. 2020 Sep;107(10):1281-1288
pubmed: 32259297
Br J Surg. 2008 Mar;95(3):357-62
pubmed: 17933001
Ann Surg. 2019 Feb;269(2):344-350
pubmed: 29099400
Ann Surg. 2016 Nov;264(5):754-762
pubmed: 27741008
JAMA Surg. 2015 May;150(5):416-22
pubmed: 25761143
Am J Surg. 2018 Feb;215(2):282-287
pubmed: 29174164
HPB (Oxford). 2020 Mar;22(3):452-460
pubmed: 31445781
HPB (Oxford). 2020 Apr;22(4):603-610
pubmed: 31551139
Ann Surg. 2020 Jan;271(1):1-14
pubmed: 31567509
Br J Surg. 2017 Oct;104(11):1443-1450
pubmed: 28895142
Am J Surg. 2019 Feb;217(2):256-260
pubmed: 30518480
J Gastrointest Surg. 2021 Aug;25(8):2119-2128
pubmed: 33948865
Ann Surg. 2009 May;249(5):744-9
pubmed: 19387336
HPB (Oxford). 2021 Apr;23(4):520-527
pubmed: 32859493
Ann Surg. 2020 Nov;272(5):731-737
pubmed: 32889866
Lancet. 2009 Sep 26;374(9695):1105-12
pubmed: 19782876
Ann Surg. 2018 Mar;267(3):552-560
pubmed: 28045744
Ann Surg Oncol. 2021 Oct;28(11):6273-6282
pubmed: 33791900
N Engl J Med. 2002 Apr 11;346(15):1128-37
pubmed: 11948273