Otsubo T, Kobayashi S, Sano K et al.
Member of the JSHBPS board of director in charge of the JSHBPS Safety Management Committee, Tokyo, Japan.
Journal of hepato-biliary-pancreatic sciences. Mar 2017.
We investigated safety-related outcomes of HBP surgeries performed after establishment of the Japanese Society of Hepato-Biliary-Pancreatic Surgery board certification system for expert surgeons.We analyzed post-HBP surgery mortality data obtained from annual safety reports provided by board-certified training institutions between 2012 and 2015.The 90-day mortality rate for the 53,929 high-level HBP surgeries performed at board-certified training institutions was 1.7%. The 30-day mortality rates for 2012, 2013, 2014, and 2015 were 0.9%, 0.7%, 0.6%, and 0.6%, respectively, and the 90-day mortality rates were 2.1%, 1.8%, 1.6% and 1.3%, respectively, with significant decreases in both. The surgeries with high 4-year cumulative mortality rates were left hepatic trisectionectomy (10.3%), hepatopancreatectomy (7.6%), liver transplantation recipient surgery (6.7%), hepatectomy with extrahepatic bile duct resection (4.6%), and right hepatic trisectionectomy (4.5%). Over the 4-year period, the number of operations increased, but the 90-day mortality rates for these surgeries, with the exception of right trisectionectomy, decreased.The board certification system for expert surgeons has significantly decreased mortality subsequent to high-level HBP surgeries. Reducing mortality associated with high-risk HBP surgeries will be our next challenge. This article is protected by copyright. All rights reserved.