Optimal Pancreaticoduodenectomy Volume for Specialist Services

A systematic review and spline regression analysis of 33 cohort studies involving 198,377 patients were conducted to determine the minimum volume threshold required for a specialist pancreas service to achieve optimal outcomes. The results showed that 55 pancreaticoduodenectomies (PDs) per year were needed to achieve the lowest morbidity, while 43 PDs per year were required for the highest lymph node harvest. A minimum threshold of 45 PDs per year was necessary for mortality benefit, with the optimum value at approximately 70 PDs per year. No significant association was found for cost and length of stay.