Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project)

<b>Background/Objectives:</b> Like many other countries, the management of pancreatic cancer in Spain has developed in a fragmented manner. This study analyzes clinical outcomes related to patient volume at different centers after left pancreatectomy (LP). Our goal is to determine whether our practices align with the standards established in the literature and assess whether centralization's advantages significantly outweigh its disadvantages. <b>Methods:</b> The SPANDISPAN Project (SPANish DIStal PANcreatectomy) is an observational, prospective, multicenter study focused on LP conducted in Spanish Hepato-Pancreato-Biliary (HPB) Surgery Units from 1 February 2022 to 31 January 2023. HPB units were defined as high volume if they performed more than 10 LPs annually. <b>Results:</b> This study included 313 patients who underwent LP at 42 centers across Spain over the course of a year. A total of 40.3% of the procedures were performed in high-volume centers. Significant differences in preoperative variables were only observed in ASA scores, which were higher in the high-volume group. Intraoperatively, minimally invasive surgical techniques were performed more frequently in high-volume centers. Postoperatively, the administration of somatostatin, major complications, and B and C postoperative pancreatic fistula (POPF) were more frequent in low-volume hospitals. <b>Conclusions:</b> The findings revealed that high-volume centers had a higher rate of minimally invasive surgery, lower intraoperative bleeding, fewer complications, and reduced POPFs compared to low-volume centers. However, it is important to note that low-volume centers still demonstrated acceptable outcomes. Thus, the selective referral of more complex laparoscopic procedures could initiate a gradual centralization of surgical practices.

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Journal
Journal of Clinical Medicine
Published
2025-08-25
DOI
https://doi.org/10.3390/jcm14176013
Primary Topic
Pancreatic and Hepatic Oncology Research
Type
article
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article

Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project)

Francisco J. Alcalá, Mario Serradilla‐Martín, Javier Mínguez, Manuel González et al.
Journal of Clinical Medicine
Pancreatic and Hepatic Oncology Research
article

Effect of Volume on Postoperative Outcomes After Left Pancreatectomy: A Multicenter Prospective Snapshot Study (SPANDISPAN Project)

Francisco J. Alcalá, Mario Serradilla‐Martín, Javier Mínguez, Manuel González, Fernando Rotellar, Carmen Payá‐Llorente, Belinda Sánchez Pérez, Enrique Asensio, Elsa Marques, Marina Garcés‐Albir, Alberto Miyar, Isabel Jaén-Torrejimeno, Manuel Nogueira Sixto, Miguel Ángel Gómez‐Bravo, Carmen González‐Lois, Miguel Manzanares, Luis Secanella, Enrique Artigues, Juan Luís Blas, Pablo Martí‐Cruchaga, G. Suárez Artacho, Inmaculada Lasa-Unzué, Carlos Domingo del Pozo, José E. Quiñones Sampedro, Belén Hernández, Santiago López‐Ben, Carmelo Loinaz, Enrique Toledo, Santiago Sánchez-Cabús, C. Alcázar, Natalia Zambudio-Carroll, Daniel Aparicio-López, Fernando Burdı́o, Alfredo Escartín, Alicia Calero, M. Rodríguez-López, Cristina Ballester Ibáñez, C. Villodre, Rafael López‐Andújar, María Galofré-Recasens, Juan Jesús Rubio-García, M I García-Domingo, Miguel Ángel Suárez Muñóz, Juli Busquets, Gerardo Blanco‐Fernández, Sergio Estévez-Fernández, Gabriel García-Plaza, Jorge Calvo, Mar Achalandabaso Boira, Luís Sabater, Julio Santoyo Santoyo, José Manuel Ramia, Fulthon Vela, María José Castro, Francisco Espín Álvarez, Gloria Palomares, Itziar de-Ariño-Hervás, José I. Miota-de-Llamas, Benedetto Ielpo, David Pacheco, Luis Iglesias Díez, Míriam Alkorta, Ana B. Vico-Arias, Berta Tió, Esteban Cugat, J. García i Castell, Núria Peláez, Benito González Conde, Alberto Carabias, Alejandro Pérez, Lorena Solar, Belén Martín-Arnau, Eider Etxebarría, Jorge Roldán-de-la-Rua, Angélica Blanco-Rodríguez, Pilar Elena González-de-Chaves-Rodríguez, Betsabé Reyes-Correa, María Paloma Sanz-Muñóz, Antonio Calvo-Córdoba
article en

Abstract

<b>Background/Objectives:</b> Like many other countries, the management of pancreatic cancer in Spain has developed in a fragmented manner. This study analyzes clinical outcomes related to patient volume at different centers after left pancreatectomy (LP). Our goal is to determine whether our practices align with the standards established in the literature and assess whether centralization's advantages significantly outweigh its disadvantages. <b>Methods:</b> The SPANDISPAN Project (SPANish DIStal PANcreatectomy) is an observational, prospective, multicenter study focused on LP conducted in Spanish Hepato-Pancreato-Biliary (HPB) Surgery Units from 1 February 2022 to 31 January 2023. HPB units were defined as high volume if they performed more than 10 LPs annually. <b>Results:</b> This study included 313 patients who underwent LP at 42 centers across Spain over the course of a year. A total of 40.3% of the procedures were performed in high-volume centers. Significant differences in preoperative variables were only observed in ASA scores, which were higher in the high-volume group. Intraoperatively, minimally invasive surgical techniques were performed more frequently in high-volume centers. Postoperatively, the administration of somatostatin, major complications, and B and C postoperative pancreatic fistula (POPF) were more frequent in low-volume hospitals. <b>Conclusions:</b> The findings revealed that high-volume centers had a higher rate of minimally invasive surgery, lower intraoperative bleeding, fewer complications, and reduced POPFs compared to low-volume centers. However, it is important to note that low-volume centers still demonstrated acceptable outcomes. Thus, the selective referral of more complex laparoscopic procedures could initiate a gradual centralization of surgical practices.

Journal of Clinical MedicineVol. 14(17)
Universitat de Miguel Hernández d'Elx (ES), University of Alicante (ES), Hospital Universitario Insular de Gran Canaria (ES), Hospital Universitario La Paz (ES), Hospital de Sant Pau (ES), Bellvitge University Hospital (ES), Hospital Universitari Arnau de Vilanova (ES), University Hospital Complex Of Vigo (ES), Hospital Clínico San Carlos (ES), Hospital Universitari i Politècnic La Fe (ES), Hospital Universitario Nuestra Señora de Candelaria (ES), Hospital General Universitario Morales Meseguer (ES), Hospital de Basurto (ES), Hospital La Luz (ES), Hospital Clínico Universitario de Valencia (ES), University Hospital Mútua de Terrassa (ES), Complejo Hospitalario de Salamanca (ES), Marqués de Valdecilla University Hospital (ES), Biogipuzkoa Health Research Institute (ES), Hospital Universitario 12 De Octubre (ES), Hospital Royo Villanova (ES), Hospital Universitario de Getafe (ES), Hospital Universitario Príncipe de Asturias (ES), Hospital Regional Universitario de Málaga (ES), Instituto de Investigación Biosanitaria de Granada (ES), Hospital General Universitario de Elche (ES), Hospital Universitario Virgen de las Nieves (ES), Hospital General Universitario de Ciudad Real (ES), Instituto Bernabeu (ES), Hospital Universitario Doctor Peset (ES), Hospital General Universitario De Valencia (ES), Hospital Del Mar (ES), Hospital Universitario Central de Asturias (ES), Clinica Universidad de Navarra (ES), Hospital General Universitario de Alicante Doctor Balmis (ES), Centro de Implantología Cirugía Oral y Maxilofacial (ES), Donostiako Unibertsitate Ospitalea (ES), Complexo Hospitalario Universitario A Coruña (ES), Hospital Universitario Puerta del Mar (ES), Hospital General Universitario de Albacete (ES), Hospital General de Elda (ES), Hospital Universitario Virgen del Rocío (ES), Hospital Universitari Germans Trias i Pujol (ES), Hospital Universitari de Girona Doctor Josep Trueta (ES), Hospital General San Jorge (ES), Hospital Clínico Universitario Virgen de la Victoria (ES), Hospital Clínico Universitario de Valladolid (ES), Hospital Universitario Río Hortega (ES), Hospital Universitario Infanta Leonor (ES)
Openalex Percentile: Top 69%
Pancreatic and Hepatic Oncology Research
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