Aim: Over the past decade, several centralization programs for major pancreatic surgery have been implemented in hospitals with high procedural volumes. Although the impact of this process was altogether positive, also possible negative effects have been evidenced, above all the lack of comprehensive coverage and access to specialized centers. In order to solve these problems, it was proposed the utilization of an outcome-based and not volume-based center selection. For this purpose the choice of an appropriate outcome assessment system is crucial.
Material of study: We retrospectively reviewed 74 patients undergoing pancreatoduodenectomy. The outcomes were evaluated utilizing the Accordion Severity Classification of Postoperative Complications.
Results: The morbidity of 58 % and the mortality of 4 % were comparable with the ones reported in large series utilizing the same classification system.
Conclusions: The Accordion system is an effective method of quality control for pancreatic surgery both in high- and low-volume hospitals.