Mortality, morbidity, and survivals are similar (19),(20). The learning curve in pancreatic surgery suggested that after 60 PD’s, there are improved outcomes of estimated blood loss, operative time, length of stay, and margin status— factors
which have been associated with overall outcome (21). The results presented in this study are consistent with the conclusions presented by published literature. #Dasatinib CAS randurls[1|1|,|CHEM1|]# The benefits of regionalization of complex surgery were Inhibitors,research,lifescience,medical demonstrated in a number of studies. Benefits of a high volume center include a decrease in mortality and cost and the ability to perform prospective randomized trials and to provide surgical training (22),(23). Figure 3 Survival analyzed with respect to ASA score One of the goals of this study is to determine if we can provide excellent care to patients diagnosed with periampullary Inhibitors,research,lifescience,medical tumors. The closest medical center with pancreaticobiliary service to our center is approximately 90 miles. Given the choice for location of service, an overwhelming majority of patients preferred not to travel long distances. Having a pancreaticobiliary service in our encatchment area serves to facilitate treatment
as well as to allow patient’s family members easier Inhibitors,research,lifescience,medical access to the treating medical center. There has been a dramatic improvement of surgical care in treating periampullary tumors over the last two decades. Anesthetic and perioperative care during Inhibitors,research,lifescience,medical the duration of our study have made the greatest contribution to decreasing perioperative mortality. The development of clinical pathways also has contributed to optimizing the outcome (24). There are limitations to a single institutional series such as ours. Patient
population is not large. Because of the small number of patients, meaningful statistical analysis is difficult to derive. Morbidity, mortality, and long term outcomes (cancer specific survival, overall survival) nevertheless have utility in assessing a cancer program. The data Inhibitors,research,lifescience,medical presented here gives support to continuing the pancreaticobiliary program at our institution. Our results reflect the dedication of specialists with interest in treating pancreaticobiliary disorders. We assert that hospital volume alone cannot be the sole determinant of outcome. It is our belief that surgeon volume combined with a multidisciplinary approach and excellent Entinostat ancillary support provide an excellent prediction of survival as demonstrated in this study of patients with pancreatic and biliary malignancies. The factors contributing to improved survival for patients diagnosed with periampullary tumors are numerous. Improved perioperative critical care and improved surgical care decrease operating time. Advances in kinase inhibitor KPT-330 adjunctive therapies contribute to improved survival. It is through these novel therapies that we will see further improvement in survival rates (25).