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Volume–outcome relationship of liver surgery: A nationwide analysis

British Journal of Surgery Mar 29, 2020

Olthof PB, Elfrink AKE, Marra E, et al. - In view of an abundant evidence for an association between hospital volume and outcomes for liver surgery, researchers examined if and how hospital volume is associated with postoperative outcomes using data from the nationwide Dutch Hepato Biliary Audit. In this nationwide study performed in the Netherlands, inclusion of all liver resections reported in the Dutch Hepato Biliary Audit between 2014 and 2017 was done. Across 34 centers, a total of 5,590 liver resections were performed with a median annual center volume of 35 (i.q.r. 20–69) procedures. More major liver resections, and more resections for hepatocellular carcinoma and biliary cancer were performed at higher‐volume centers. Outcomes do not support the association between hospital volume and postoperative outcomes. The existing advanced patient selection across lower‐ and higher‐volume centers in regional collaboration may explain the lack of a volume–outcome relationship. 

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