Background

Pancreaticoduodenectomy (PD) or Whipple’s operation is performed on patients with a diagnosis of pancreatic, biliary tract or duodenal cancer.  We investigated patterns of PD performed in Queensland hospitals during the period 2003 to 2012.  Increased postoperative mortality rates have previously been observed in hospitals performing very low annual volumes of PD.

Methods

Patterns of surgery across Queensland hospitals for the period were assessed according to annual surgical volume.  Queensland hospitals performing PD were categorised as being very low volume hospitals (average <3 per year); low volume hospitals (average 3-9 per year); and high volume (> 9 per year.

Results

A PD was performed on twelve percent of Queensland patients diagnosed with these cancers between 2003 and 2012.   

Surgery was performed in 22 Queensland hospitals during the period, with four capital city hospitals accounting for over half of all surgeries.  Fifteen hospitals averaged less than three operations per year for the ten year period.  Seven of these hospitals have not performed a PD since 2006. 

The number of very low volume hospitals performing PD in a given year has declined from eight - ten during 2003-2006 to three from 2007-2012.  There has been one postoperative death in a low volume hospital and three deaths in high volume hospitals during the period 2008-2012.

Conclusions