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Volume-Outcome Relationship in Oncological Surgery pp 35–44Cite as

Volume-Outcome Relationship in Hepatobiliary Surgery

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Part of the book series: Updates in Surgery ((UPDATESSURG))

Abstract

The positive relationship between volume and outcome in hepatobiliary surgery has long been demonstrated. As for other complex surgical procedures, improved both 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 and 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 of the many determinants involved, some of which cannot be easily controlled. In the context of different health systems worldwide, such as national health systems and private insurances, there are different stakeholders that express different needs: politicians, patients, surgeons, institutions and medical associations do not have always the same needs. Starting from a review of the literature on centralization in hepatobiliary surgery, this chapter will propose some guidelines that, when not data-driven due to low levels of evidence in the literature, will be based on good clinical practice.

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Author information

Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Matteo Donadon & Guido Torzilli

  2. Department of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy

    Matteo Donadon, Eloisa Franchi & Guido Torzilli

Authors
  1. Matteo Donadon
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  2. Eloisa Franchi
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  3. Guido Torzilli
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Corresponding author

Correspondence to Guido Torzilli .

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Editors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Marco Montorsi

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Donadon, M., Franchi, E., Torzilli, G. (2021). Volume-Outcome Relationship in Hepatobiliary Surgery. In: Montorsi, M. (eds) Volume-Outcome Relationship in Oncological Surgery. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-51806-6_5

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  • DOI: https://doi.org/10.1007/978-3-030-51806-6_5

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