[荷兰胰十二指肠部分切除术后的医院经历及医院死亡率]
[Hospital experience and hospital mortality following partial pancreaticoduodenectomy in The Netherlands].
作者信息
Gouma D J, De Wit L T, Van Berge Henegouwen M I, Van Gulik T H, Obertop H
机构信息
Universiteit van Amsterdam/Academisch Medisch Centrum, afd. Chirurgie.
出版信息
Ned Tijdschr Geneeskd. 1997 Sep 6;141(36):1738-41.
OBJECTIVE
To analyse the effect of hospital experience on mortality after subtotal pancreaticoduodenectomy in the Netherlands.
DESIGN
Retrospective evaluation.
METHOD
Information on hospital mortality and pancreatic resection in 1994 and 1995 in the Netherlands was obtained from the National Medical Register. Subanalysis was carried out of surgical mortality by age and hospital experience.
RESULTS
Approximately 50% of the pancreaticoduodenectomies in the Netherlands were performed in hospitals with limited experience (< 5 procedures per year). Hospital mortality was higher in small-volume hospitals than in hospitals with experience (> 25 procedures per year): in 1994 17.2 and 0% and in 1995 14.6 and 2.9%, respectively (p < 0.05). Mortality was higher in patients older than 70 years compared with patients younger than 55 (p < 0.05).
CONCLUSION
There was a correlation between mortality after pancreaticoduodenectomy and hospital experience. Therefore these procedures should be performed in centres with experience.
目的
分析荷兰医院经验对胰十二指肠次全切除术后死亡率的影响。
设计
回顾性评估。
方法
从国家医疗登记处获取1994年和1995年荷兰医院死亡率及胰腺切除术的信息。按年龄和医院经验对手术死亡率进行亚分析。
结果
荷兰约50%的胰十二指肠切除术在经验有限的医院（每年<5例手术）进行。小容量医院的医院死亡率高于有经验的医院（每年>25例手术）：1994年分别为17.2%和0%，1995年分别为14.6%和2.9%（p<0.05）。70岁以上患者的死亡率高于55岁以下患者（p<0.05）。
结论
胰十二指肠切除术后死亡率与医院经验之间存在相关性。因此，这些手术应在有经验的中心进行。
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