@article{Ignatavicius2022837,

title = {The essential requirements for an HPB centre to deliver high-quality outcomes},

author = {Povilas Ignatavicius and Christian E. Oberkofler and Jan Philipp Jonas and Beat Mullhaupt and Pierre-Alain Clavien},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85133814509&doi=10.1016%2fj.jhep.2022.04.036&partnerID=40&md5=0c728970dca866a93c1aa7bc05d8fc53},

doi = {10.1016/j.jhep.2022.04.036},

issn = {01688278},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Journal of Hepatology},

volume = {77},

number = {3},

pages = {837 – 848},

publisher = {Elsevier B.V.},

abstract = {The concept of a centre approach to the treatment of patients with complex disorders, such as those with hepato-pancreato-biliary (HPB) diseases, is widely applied, although what is needed for an HPB centre to achieve high-quality outcomes remains unclear. We therefore conducted a literature review, which highlighted the paucity of information linking centre structure or process to outcome data outside of caseloads, specialisation, and quality of training. We then conducted an international survey among the largest 107 HPB centres with experts in HPB surgery and found that most responders work in ‘virtual’ HPB centres without dedicated space, assigned beds, nor personal. We finally analysed our experience with the Swiss HPB centre, previously reported in this journal 15 years ago, disclosing that budget priorities set by the hospital administration may prevent the development of a fully integrated centre, for example through inconsistent assignment of the centre's beds to HBP patients or removal of dedicated intermediate care beds. We propose criteria for essential requirements for an HPB centre to deliver high-quality outcomes, with the concept of “centre of reference” limited to actual, as opposed to virtual, centres. © 2022 European Association for the Study of the Liver},

note = {Cited by: 1; All Open Access, Bronze Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33330823,

title = {Effects of volume on outcome in hepatobiliary surgery: a review with guidelines proposal},

author = {Eloisa Franchi and Matteo Donadon and Guido Torzilli},

doi = {10.35772/ghm.2020.01013},

issn = {2434-9194},

year  = {2020},

date = {2020-10-01},

urldate = {2020-10-01},

journal = {Glob Health Med},

volume = {2},

number = {5},

pages = {292--297},

abstract = {The positive relationship between volume and outcome in hepatobiliary surgery has been demonstrated for many years. As for other complex surgical procedures, both improved short- and long-term outcomes have been associated with a higher volume of procedures. However, whether the centralization of complex hepatobiliary procedures makes full sense because it should be associated with higher quality of care, as reported in the literature, precise criteria on what to centralize, where to centralize, and who should be entitled to perform complex procedures are still missing. Indeed, despite the generalized consensus on centralization in hepatobiliary surgery, this topic remains very complex because many determinants are involved in such a centralization process, of which some of them cannot be easily controlled. In the context of different health systems worldwide, such as national health systems and private insurance, there are different stakeholders that demand different needs: politicians, patients, surgeons, institutions and medical associations do not always have the same needs. Starting from a review of the literature on centralization in hepatobiliary surgery, we will propose some guidelines that, while not data-driven due to low evidence in the literature, will be based on good clinical practice.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Torzilli2016135,

title = {Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it},

author = {Guido Torzilli and Luca Viganò and Felice Giuliante and Antonio Daniele Pinna},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84975883348&doi=10.1007%2fs13304-016-0373-0&partnerID=40&md5=227c0fc1a39abc167f5acd593a7dac0b},

doi = {10.1007/s13304-016-0373-0},

issn = {2038131X},

year  = {2016},

date = {2016-01-01},

urldate = {2016-01-01},

journal = {Updates in Surgery},

volume = {68},

number = {2},

pages = {135 – 142},

publisher = {Springer-Verlag Italia s.r.l.},

abstract = {During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate < 3 %. Finally, the organization requirements: the presence of specific diagnostic–therapeutic flowcharts for liver diseases. © 2016, Italian Society of Surgery (SIC).},

note = {Cited by: 14},

keywords = {},

pubstate = {published},

tppubtype = {article}

}